Senior Coordinator, Accounts Receivable - Monroeville, PA (Hybrid)

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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Senior Coordinator, Accounts Receivable is responsible for analysis of contracts and payor agreements, amendments and fee schedules to ensure efficient, timely and accurate system payor creation and set-up in support of timely and accurate billing and collections. This position is also responsible for reimbursement analysis between actual payment experience and/or D.0 payment response and contract terms, including root cause analysis, impact analysis, recommended next steps and implementation of approved recommendations.

Role Overview

• Hybrid Role

Responsibilities

• Analyze Payor contracts, amendments, and payor notifications to drive efficient and accurate payor and pricing set up and maintenance in compliance with documented contracts and agreements.
• Act as a liaison between internal departments and payors in support of resolution of contract specific issues, such as claims processing, pricing/reimbursement, and formulary issues. 
• Preparing spreadsheets, reports, pivot tables and payor analysis to effectively communicate via written or verbal to senior management for complex payer issues.
• Preparation and coordination for all internal SOX Audits
• Complete analysis of incoming Code and Bill Group Maintenance Requests in preparation of assigning to payer relations associates for the creation and maintenance of proper payer code configuration.
• Participates in development of organizational procedures such as job aids, forms and manuals as needed. Assist with peer training and new hire support. 
• Review and approve department escalated Payor Code recommended configuration by Payer Relations team.
• Creation and maintenance of prebill/prefill and procedure code set up in compliance with documented contracts, state regulated requirements, and business requests.
• Act as a liaison between internal departments and payors in support of resolution of contract specific issues, such as claims processing, conversion issues, and prefill edits.

Required Qualifications

• 2-3 years Health Care Insurance Payer Interface experience
• Ability to Analyze reports
• Exhibits good judgment when escalating issues to management
• Ability to complete projects and adhere to deadlines
• Must live within a 1 hour commute from the Monroeville, PA office.

Preferred Qualifications

• Excellent organizational and prioritization skills
• Excellent verbal, written and communication skills
• Excellent Analytical Skills
• Ability to gather, compile and prepare reports
• Associated degree preferred

Education

• High School Diploma or GED

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and ot