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Pharmacy Billing Representative - Monroeville, PA (Hybrid)



Monroeville, PA, USA
Posted on Monday, June 10, 2024

Bring your heart to CVS Health. Every 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.

Position Summary
CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area, has an opportunity available for a full time Pharmacy Billing Representative. This role will ensure timely and accurate billing for unbilled claims and ensure account payment for outstanding balances while demonstrating excellent customer service to patients, healthcare professionals, and insurance carriers. As part of the Revenue Cycle team, you will work in a fast paced and team focused environment. We will support you by offering all the tools and resources you need to be successful in a collaborative team-based environment. Located in the Monroeville facility, this opportunity also provides free parking.

Role Overview

  • Schedule: Monday-Friday 8:00AM-4:30PM EST (Flex Start after training)
  • Hybrid Role
  • Training: 2-3 weeks of training

What you will do

  • Third party insurance claim billing and follow up associated with the dispensing of prescription medication using the bill method required by the payer.
  • Transmit or submit claims (paper, electronic) to insurance payers for reimbursement.
  • Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes, and pharmacy or shipping errors.
  • Maintain supporting chronological notes that detail actions taken to resolve outstanding unbilled claims.
  • Maintain patient demographic information in data collections systems.
  • Work all billing reports and queues while remaining in accordance with payer and company policy guidelines.
  • Research and respond by telephone, via the internet, and in writing to patients, physician's offices, insurance companies, and governmental payers regarding billing issues and problems as well to expedite claims processing.

Required Qualifications

  • 1+ year(s) experience performing healthcare reimbursement, medical insurance billing, collections, or related work.
  • Must live within a 1 hour commute to the Monroeville, PA office.

Preferred Qualifications

  • Billing/Collections experience.
  • Customer service in healthcare environment.
  • Experience working with a healthcare reimbursement system.
  • Ability to communicate with clientele in a professional manner; both verbally and written.
  • Attention to detail.
  • Ability to utilize analytical skills.
  • Effective customer service skills and experience that shows ability to work in a team environment.
  • Experience in MS Office, specifically Excel, Outlook, and Word.


  • Verifiable High School Diploma or GED required.

Pay Range

The typical pay range for this role is:

$17.00 – $28.45

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 other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/04/2024