Medical Reimbursement Representative

Job DescriptionCVS Health has an exciting opportunity for you to join a growing team As a Collector, you play an integral role in delivering cost effective solutions for our patients by working with insurance companies to resolve issues associated with our patients' insurance this role you will ensure timely follow-up on all patient accounts; including escalating payer trending concerns to leadership and timely communication with external departments; work with payers to ensure proper reimbursement on patient accounts, identify and prepare adjustments and write-offs; correct and resubmit claims (subject to policy); follow-up on daily correspondence (denials, short-pays); interface with insurance companies via phone and web portal to check claim status, submit written correspondence to payers and patients; interpret contracts with payers to ensure proper payment; send initial or secondary bills to insurance companies; process refunds and work to overturn insurance claim rejections while maintaining quality and productivity requirements. To be successful in this role you will utilize Excel, Outlook, and Word and your critical thinking skills to ensure a high quality of work. We offer instructor led training programs to set you up for success, in addition to a comprehensive benefits package that begins the first of the month after your start date and includes medical, dental and vision insurance as well as supplemental benefits, retail discounts and paid time off. Additionally, we offer a flexible work schedule, starting your 8-hour day between 6:00am and 9:30am ending your day by 6:00pm. some locations require a 7:00am start timeRequired Qualifications- 1+ years of experience in a professional environment; beginner level experience working in Excel, Outlook, and Word.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- Home infusion or durable medical equipment (DME) experience.- Strong attention to detail with a sense of urgency. - Customer service skills.- Ability to work in a team environment.- Experience with medical billing or collections or experience with accounts payable (AP) or accounts receivable (AR).- Experience with Healthcare reimbursement systems.Education- Verifiable High School Diploma or GED required.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-09-06