About the Company
CVS Health is a leading healthcare company that offers a wide array of services including pharmacy benefits management, retail pharmacy, minute clinic, and disease management programs. We are dedicated to helping people on their path to better health, focusing on innovation and customer-centric solutions. Join our team and contribute to a healthier community.
Job Description
We are seeking a detail-oriented and experienced Pharmacy Billing Associate with a strong focus on insurance and finance to join our team in New Port Richey, FL. In this role, you will be responsible for managing and processing pharmacy claims, ensuring accurate billing, and resolving any discrepancies with insurance providers. Your expertise in navigating complex insurance policies and financial regulations will be crucial to our operational success and patient satisfaction. This is an on-site position requiring strong organizational skills and a commitment to accuracy.
Key Responsibilities
- Process pharmacy claims accurately and efficiently through various billing systems.
- Verify patient insurance coverage and eligibility for prescribed medications.
- Resolve claim rejections and denials by performing necessary research, corrections, and resubmissions.
- Communicate effectively with insurance companies, prescribers, and patients to clarify billing information and resolve issues.
- Maintain up-to-date knowledge of insurance policies, billing regulations, and reimbursement guidelines.
- Reconcile payment discrepancies and manage accounts receivable related to pharmacy services.
- Assist with financial reporting and audits as required.
- Ensure compliance with all federal, state, and local billing regulations, including HIPAA.
- Provide exceptional customer service regarding billing inquiries.
Required Skills
- Minimum 1 year of experience in pharmacy billing or medical billing with a strong emphasis on insurance.
- Proficiency with pharmacy billing software and electronic health records (EHR) systems.
- In-depth knowledge of various insurance plans, including commercial, Medicare, Medicaid, and managed care.
- Strong understanding of pharmacy terminology, CPT codes, ICD-10 codes, and modifiers.
- Excellent communication and interpersonal skills.
- Exceptional attention to detail and accuracy.
- Ability to work independently and as part of a team in a fast-paced environment.
- High school diploma or equivalent.
Preferred Qualifications
- Pharmacy Technician certification (CPhT).
- Associate's or Bachelor's degree in a related field (e.g., healthcare administration, finance).
- Experience with CVS Health's specific billing systems and procedures.
- Familiarity with state and federal pharmacy regulations in Florida.
Perks & Benefits
- Comprehensive health, dental, and vision insurance plans.
- 401(k) retirement savings plan with company match.
- Paid time off (vacation, sick leave, holidays).
- Employee discount program at CVS retail stores.
- Tuition reimbursement and professional development opportunities.
- Life insurance and disability benefits.
- Employee assistance program.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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