We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

• Act as a subject matter expert (SME) for all revenue cycle AR related to Infusion & Enteral and associated interfaces
• Conducts data analysis and performs financial reviews to identify opportunities for revenue cycle improvement, including areas such as coding, billing, and reimbursement.
• Coordinates with cross-functional teams, including finance, billing, and coding departments, to identify and resolve revenue cycle issues, ensuring accurate and timely reimbursement.
• Under close supervision monitors key performance indicators (KPIs) and metrics related to revenue cycle management, providing regular reports and insights to management for decision-making and performance evaluation.
• Assists in the development and implementation of revenue cycle improvement initiatives, such as process enhancements, technology solutions, and training programs.
• Conducts audits and reviews to ensure compliance with coding, billing, and reimbursement regulations, identifying areas of non-compliance and implementing corrective actions.
• Assists in the development and maintenance of revenue cycle policies, procedures, and documentation, ensuring adherence to regulatory requirements and industry best practices.
• Coordinates with revenue cycle stakeholders to optimize revenue capture, streamline workflows, and improve operational efficiency.
• Works with revenue cycle staff, including training on coding and billing practices, addressing inquiries, and resolving complex issues.
• Stays informed about industry trends, changes in healthcare regulations, and advancements in revenue cycle management practices.
• Analyze and resolve complex payer issues within established time frames.

Required Qualifications

• 5 or more years of revenue cycle experience, including a minimum of 3 years of Healthcare Industry billing experience.

Preferred Qualifications

• Experience working with revenue cycle applications and healthcare finance and accounting principles.
• Familiarity with Specialty pharmacy and/or post-acute operations
• Ability to multi-task and manage multiple projects or trainings at one time.
• Knowledge of federal, state and commercial payer reimbursement rules and regulations.

• Exceptional organizational skills and the ability to effectively prioritize work, multi-task, and follow through on assignments.
• Strong presentation skills.
• Excellent oral, written, and interpersonal communication skills.
• Prior experience with AR reporting including trending, aging, forecasting, etc.
• Skilled in use of MS Office Applications, particularly Excel.
• Ability to translate and effectively analyze large data sets.
• Highly motivated self-starter with the ability to work both independently and as a part of a cross-functional team.
• Strong working knowledge of Windows-based software applications (e.g., Word, PowerPoint, Excel, Visio).

Education

• Verifiable High School Diploma or GED required.
• Bachelor's degree preferred.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.