Senior Lead Coordinator, Revenue Cycle at CVS Health

Monroeville, Pennsylvania, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmacyIndustries

Requirements

2+ years of Healthcare Insurance related experience
Experience using Microsoft Office products, specifically Excel, Outlook, and Word
Must be able to commute to the Monroeville, PA office
Verifiable High School Diploma or GED required

Responsibilities

Review routine reports to ensure department Key Performance Indicators and Metrics are consistently met. Provide feedback to leaders and colleagues regarding areas of success and concern and suggest mitigation plans
Identify and quantify trends and variances. Effectively communicate information to the appropriate members of the management team along with the potential impact
Assist leadership in building and maintaining a high performing, highly engaged team
Provide excellent mentorship and support to the department’s colleagues
Assist in designing and implementing department level training programs and lead job specific training for department new hires and for upskills training
Assist with working complex accounts related to insurance billing and collections and other third party insurance claim billing associated with the dispensing medication and using the bill method required by the payer
Resolve complex insurance problems and patient inquiries that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors
Maintain supporting and chronological notes that detail action taken to resolve billing edits
Maintain patient demographic and insurance information and data collections systems, including all
Complete billing reports, queues, or diversions according to payer and company policy guidelines
Research and respond to insurance companies and governmental payors regarding billing issues or related questions by telephone, via the internet, and in writing
Contact patients, physician's offices or insurance carriers as needed in order to expedite billing claims

Skills

Key technologies and capabilities for this role

Revenue Cycle ManagementBillingCollectionsKPI AnalysisTeam LeadershipMentorshipTrend AnalysisPerformance MetricsCustomer ServiceClaims ProcessingReimbursement

Questions & Answers

Common questions about this position

Is this a remote position or does it require on-site work?

This is an on-site position located in the Monroeville facility, with free parking provided.

What is the salary range for this Senior Lead Coordinator role?

This information is not specified in the job description.

What key skills are required for the Billing and Collections Revenue Cycle Management Team Lead?

Key skills include reviewing reports for KPIs and metrics, resolving complex insurance billing and collections issues, maintaining patient demographic and insurance data, researching payer issues, and providing mentorship and training to team members.

What is the work environment like at CVS Health Specialty Pharmacy?

The environment is fast-paced and team-focused, with collaborative support including all tools and resources needed for success.

What makes a strong candidate for this Team Lead position?

Strong candidates excel in leadership, mentorship, analyzing trends and KPIs, resolving complex billing issues, and training new hires in a team-oriented setting.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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