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Data Entry - Billing Claims Representative
at CVS Health
We have a great opportunity to launch a career in a pharmacy operation setting as a Data Entry - Billing Claims Representative for Coram's Home Infusion Services. In this role, you will join a brand new team that handles billing for our new National Council of Prescription Drug Programs (NCPDP) division.
Monday - Friday 8:30AM - 5PM OR 9AM - 5:30PM. Working from home due to COVID. Post COVID, in office.
The Data Entry - Billing Claims Representative is responsible for the billing coordination of patients with payors that have unique qualifications and billing requirements for NCPDP related claims and ensuring prescription drug dispenses are adjudicated successfully for payer claim approval prior to delivery of medication without delay in patient care. Medical Billers collaborate with NCPDP Specialists to seek payer override of denied claims and assist pharmacies to plan future shipments that prevent denials.
PRIMARY DUTIES AND RESPONSIBILITIES:
1. Performs the billing of medications and or services as required for each subsequent dispense as outlined by the payor requirements.
2. Maintains the medical record in ECM with scanning results of each adjudication performed; and in HC360 through progress note entry.
3. Communicates the patient co-payment or patient financial responsibility to dispensing pharmacy.
4. Contacts payers as required in order to resolve rejected NCPDP claims and performs data entry into HC360 as required.
5. Performs data entry to complete the patient registration and adjudication in software application (CE2000).
6. Performs other duties and responsibilities as assigned
- Minimum one year of experience in medical billing or collections, accounts payable, or accounts receivable.
- Minimum one year of experience working with healthcare reimbursement systems or similar systems.
- Excellent customer service orientation.
- Attention to details and excellent time management skills.
- Proficiency in Microsoft Office software - Word, Excel, and PowerPoint.
2+ years experience in pharmacy billing
Verifiable High School Diploma or GED is required
At Coram, a CVS Health business, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.