Senior Lead Coordinator, Revenue Cycle - Orlando, FL (Hybrid) at CVS Health

Orlando, Florida, 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

3+ years Healthcare Insurance related experience
Experience using Microsoft Office products specifically Excel, Outlook, and Word
Must be able to commute to the Orlando, FL office

Responsibilities

Support the Medical Collections Team, providing guidance, training, and support to team members
Provide new hire training and maintain training documents
Lead the team in collecting or requesting rework on claims (both paper and electronic) to insurance payors for reimbursement, ensuring accuracy and timeliness
Ensure the maintenance of detailed supporting and chronological notes that document actions taken to resolve unpaid claims
Oversee the completion of collection reports, queues, or projects and initiatives as well as the collection process, ensuring accuracy and compliance with the billing standards required by various payers
Resolve escalations, complex insurance and claim issues that arise from possible incorrect or incomplete information, therapy changes, and pharmacy or shipping errors
Lead the team in researching and responding to insurance companies and governmental payors regarding payment issues or related questions through various communication channels, including telephone, internet, payor portals and written correspondence
Facilitate effective communication with patients, physician's offices, and insurance carriers to expedite billing claims. Provide training and support to team members to enhance their skills in handling these interactions
Monitor key performance indicators (KPIs) and prepare reports for leadership
Provide analysis of trends and variances to support financial decision making
Act as a liaison between the collections team and other internal departments, facilitating effective communication and collaboration

Skills

Medical Collections

Claims Processing

Collections Management

Team Leadership

New Hire Training

Claim Denials Resolution

Insurance Reimbursement

Customer Service

Paper Claims

Electronic Claims

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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