Test Claim Specialist
Posted on: 16 Mar 2021
Eden Prairie, MN
Job Description
Job Description
Coram/CVS is looking for high energy health professional to join our national team as a Test Claim Specialist. This rewarding opportunity allows you to work closely with our Patient Intake Coordinators and Insurance Providers to secure for In-Home IV Therapy for Coram/CVS specialty infusion patients. We believe that a Test Claim Specialist plays a key role in creating a positive experience for our patients. In this dynamic and fast paced role, you will be responsible for obtaining authorizations for both our new, and existing patients. This will allow us to process timely prescription orders, while demonstrating exceptional customer service to our referrals, insurance carriers and patients. This role will require an understanding of insurance carriers and concepts including drug cards, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.
Required Qualifications
*Minimum year of experience working in a healthcare environment
*Previous experience working with prior authorizations
*Knowledge of Medicare, Medicaid, and Third Party Vendors
*Analytical and problem solving skills
*Attention to detail and multi-tasking skills
*Experience working in Microsoft Office, specifically Excel, Word and Outlook
Preferred Qualifications
*Pharmacy, PBM, or Specialty Pharmacy experience
*Experience working with healthcare insurance verification
*Previous experience with medical billing procedures
Education
High School Diploma or GED
Business Overview
At Coram, a CVS Health business, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
CVS Health
Woonsocket, RI
CVS Health Corporation provides health services and plans in the United States. Its Pharmacy Services segment offers pharmacy benefit management solutions, such as plan design and administration, formulary management, retail pharmacy network management, mail order pharmacy, specialty pharmacy and infusion, Medicare Part D, clinical, disease management, and medical spend management services. The company’s Retail/LTC segment sells prescription drugs and general merchandise, such as over-the-counter drugs, beauty products, cosmetics, and personal care products, as well as provides health care services through its MinuteClinic walk-in medical clinics.
Its Health Care Benefits segment offers traditional, voluntary, and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, medical management, Medicare plans, PDPs, Medicaid health care management services, workers’ compensation administrative services, and health information technology products and services. The company’s customers include employers, insurance companies, unions, government employee groups, health plans, Medicare Part D prescription drug plans, Medicaid managed care plans, plans offered on public health insurance exchanges and private health insurance exchanges, other sponsors of health benefit plans, individuals, college students, workers, labor groups, and expatriates.
As of December 31, 2018, it had approximately 40 leased on-site pharmacies, 25 leased retail specialty pharmacy stores, 20 specialty mail order pharmacies, and 90 branches for infusion and enteral services; and 9,900 retail locations and 1,100 MinuteClinic locations, as well as operated an online retail pharmacy Websites, LTC pharmacies, and onsite pharmacies. The company was formerly known as CVS Caremark Corporation and changed its name to CVS Health Corporation in September 2014. CVS Health Corporation was founded in 1963 and is headquartered in Woonsocket, Rhode Island.
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IndustryHealthcare
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No. of Employees295, 000
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Website
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Jobs Posted4287
