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Job Information

CVS Health Pharmacy Technician - Medical Billing Specialist in Eden Prairie, Minnesota

Job Description

We have a great opportunity at our Eden Prairie Branch to launch a career in a pharmacy operation setting as a Pharmacy Technician - Medical Billing Specialist for Coram's Home Infusion Services. In this role, you will join a team that handles billing for our new National Council of Prescription Drug Programs (NCPDP) division.

As a Pharmacy Technician - Medical Billing Specialist, you will be responsible for overseeing the accounts receivable process to ensure adherence to standards and performance to goals. The Billing team will ensure claims have been processed and reviewed in a timely fashion to guarantee payment for services rendered has been received. Qualified candidates must have excellent written and verbal customer service skills and advanced computer skills in order to interact with key stakeholders and patients.

Challenge your newly acquired healthcare training or current billing knowledge and customer services skills to make a difference in a patient’s life by ensuring claims are being submitted clean to payors as to not delay the reimbursement process.

Key Responsibilities:

  • Ensure prescription drug dispenses are adjudicated successfully for payer claim approval and coordinates with pharmacy and intake teams to ensure paid claims are confirmed prior to delivery

  • Responsible for seeking override approval from payers on denied claims and coordinating with pharmacies to plan future shipments that prevent denials.

  • Contacts payers as required in order to resolve rejected NCPDP claims and performs data entry

  • Works collaboratively with the COE, branch and billing center to resolve NCPDP claim issues and participates in related audit and quality assurance activities as required.

  • Performs the billing of medications and or services as required for each subsequent dispense as outlined by the payor requirements.

  • Performs benefit and eligibility transaction as needed for patients prior to the start of care.

  • Communicates the patient co-payment or patient financial responsibility prior to or at the time of the delivery of care the branch staff.

This is a full-time, permanent career that offers excellent Medical, Dental and Vision coverage, a competitive 401k, and additional benefits.

With Coram/CVS Health, you'll have an exciting opportunity to utilize your administrative and customer service experience with a team who are passionate about making a difference in patient’s lives. You can have an impact by providing the best care, education, and support to our patients, improving their overall quality of life!

Required Qualifications

Pharmacy Technician license (National or state license required)

Minimum 2-5 years similar work experience.

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.

Excellent customer service orientation.

Attention to details and excellent time management skills.

Proficiency in Microsoft Office software – Word, Excel, and PowerPoint.

Preferred Qualifications

Associate Degree

Medical Billing certification

PDP or PBM billing in retail or home infusion

Strong attention to detail.

Ability to work in a team environment.

Ability to work with a sense of urgency

Education

Verifiable High School diploma or GED is required

Business Overview

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.

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