CVS Health

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Enrollment Coordinator Payer Relations - Senior

at CVS Health

Posted: 10/30/2020
Job Reference #: 1296505BR

Job Description

Job Description
As a Senior Enrollment Coordinator, you would execute necessary functions to ensure new and acquired pharmacies are set up to process third party claims on opening day. You perform all required tasks to enroll pharmacies in private, state and federal third party programs, as they relate to new store openings, acquisitions, and pharmacy relocation's. Support approximately 10,000 pharmacies in all enrollment related matters to assure continuation of third party agency participation. You will act as liaison between pharmacy staff, third party agencies and internal departments to research and resolve Help Desk logs relating to pharmacy enrollment.

Additional responsibilities of the Senior Enrollment Coordinator:
- Coordinate the enrollment process which includes interacting with various internal departments, field personnel, and third party agencies to obtain the information and documents that are necessary to establish participation in third party programs.
including the preparation of the enrollment contracts and notifications for stores for participation in third party programs as a result of new store openings, file buys/acquisitions, and relocations/store closings.
- Apply and gather integral provider identifiers and national enumeration system from the National Enumeration System and National Council for Prescription Drug plan for proper and timely claim adjudication.
- Enroll pharmacies in multiple Medicare programs. Process involves the submission of 1 -3 applications for approximately 300 new, closed and relocated locations per year. Ensure timely receipt of Medicare Part B provider transaction access numbers and proper notification of such numbers to Third Party A/R.
- Enroll pharmacies in various individual state Medicaid programs, as in-state and out- of state providers.

Required Qualifications
- 1+ years of customer service
- 1+ years of excel, work, and access
- 1+ years of health care, pharmacy, or medical billing environment

Preferred Qualifications
- Bachelor's degree

Verifiable High School diploma or GED

Business Overview
At CVS Health, 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.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!