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. **A Brief Overview** Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance, and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations. **What you will do** + Maintains compliance of the CAQH (Council for Affordable Quality Healthcare) database for providers within our scope of lines of businesses to gather enrollment and credentialing data in a single profile that may be accessed by participating health plans and other healthcare organizations. + Administers the process framework for the revenue cycle department, closely monitoring the status of claims to proactively identify issues or denials and devise satisfactory solutions. + Maintains compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Centers for Medicare and Medicaid Services (CMS) guidelines to mitigate organizational compliance risks. + Manages the financial analysis function and analyzes trends in accounts receivable, claim denial rates, and reimbursements. + Integrates innovative technology, tools, software, and data management systems to streamline and/or automate revenue cycle processes and procedures. + Analyzes current workflows to identify bottlenecks or inefficiencies, and implements strategies to streamline processes, reduce errors, and enhance revenue cycle outcomes. **Requirements:** + Adept at problem solving and decision making skills + Ability to work independently + Proficient in Excel + Proficient in Outlet + Willingness to learn + 1+ years of general work experience **Preferred:** + Medicare/Medicaid experience on the Provider side **Education** + High School Diploma or GED **Pay Range** The typical pay range for this role is: $18.50 - $38.82 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 Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits) We anticipate the application window for this opening will close on: 11/13/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. 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.