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

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

CVS Health Specialty Pharmacy, a mail service pharmacy in the Orlando area has an opportunity for a full-time Medical Collections Team Lead. As a Medical Collections Team Lead, you will ensure timely and accurate collections for outstanding claims, provide new hire training, resolve escalations and claim payment denials while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. As part of the reimbursement team, you will work in a fast paced and team focused environment to ensure timely and accurate collections from insurance payers.  

We will support you by offering all the tools and resources you need to be successful in a collaborative team environment. 

Located in the Orlando facility, this opportunity also provides free parking. 

Role Overview

• Schedule: Monday-Friday, 8:00AM-4:30PM EST
• Hybrid Role

Key Responsibilities of the Medical Collections Team Lead: 

• Support the Medical Collections Team, providing guidance, training, and support to team members. 
• Provide new hire training and maintain training documents. 
• Claims Collection Management: 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. 

Required Qualifications

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

Preferred Qualifications

• Ability to navigate through multiple tasks simultaneously and prioritize based on importance while displaying strong attention to detail. 
• Insurance billing or collections experience. 
• Ability to work in a team and coordinate work efforts
• Excellent communication, both orally and written, organizational, problem solving and interpersonal skills
• Ability to interact and communicate with stakeholders over the telephone, often in stressful situations
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to work independently; under minimal supervision
• Experience with A/R reporting including: trending, aging, forecasting, etc.
• Ability to