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The manager will lead billing operations and oversee teams responsible for electronic eligibility, claims billing, and payment posting. They will also collaborate cross-functionally to improve claim rates and ensure compliance with billing guidelines.
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
Leadership and Team Management: Provide leadership to critical aspects of billing operations while managing smaller teams responsible for day-to-day operations.
Team Development: Develop a team focused on managing electronic eligibility responses, timely billing of claims, accurate payment posting, and utilizing an optimized insurance follow up process.
Process Documentation: Create process documentation providing clear communication to ensure efficient, accurate, and compliant billing workflows.
Cross-Functional Collaboration: Work alongside other business leadership to provide consistent billing guidance and improve the clean claim rate
Required Qualifications
Candidates will need to have a minimum of 5-7 years of professional experience in healthcare management leading a team of individual contributors.
Experience in oversight of projects and processes that require complex resolution within both short and long term timelines.
Experience working with legal and compliance partners in support of maintaining proper billing and coding guidelines.
Baseline discipline experience as a business analyst, report writer, project manager or similar role.
Monitor KPIs and report on variances, risks and improvement process opportunities
Preferred Qualifications
Epic Professional Billing (PB Resolute) experience
Epic PB reporting (Slicer Dicer, Workbench Reporting)
AAPC certification (CPB, CPC or CRC)
Proficiency in Microsoft Office tools (Word, Excel, PowerPoint)
Excellent written and oral communication skills including development and maintenance of Standard Operating Procedures (SOP),
Ability to analyze and interpret various status and outcome reports to provide actionable insights to senior leadership.
Education
Bachelor's Degree preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$66,330.00 - $145,860.00This 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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