Medicare Part B Operations Coordinator, Revenue Cycle

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.

Job Description Summary

The Medicare Part B Operations Coordinator is responsible for supporting end to end Medicare Part B claims processing activities. This role helps ensure compliance with Centers for Medicare and Medicaid Services (CMS) requirements by facilitating accurate claim processing and submission, including manual intervention through prescriber outreach and documentation review. This function supports the Revenue Cycle Team’s objective of timely and accurate billing of pharmacy and medical claims to third party insurers.

Position Summary

As a Medicare Part B Operations Coordinator, you will support the Revenue Cycle Medicare Part B Team in efforts to reduce bad debt, mitigate legal risk and ensure compliance with all federal, state, and CVS Health requirements.

In this role, you will assist with initiatives to collect and validate prescriber documentation in accordance with CMS guidelines. Documentation collection will be conducted through prescriber outreach via fax and phone. You will be responsible for maintaining and managing a centralized repository of prescriber documentation and leveraging this data to identify actionable claim volume in alignment with established Standard Operating Procedures.

Required Qualifications

• 1+ years (retail pharmacy, PBM, account management)

• 1+ years of professional MS Excel and Access experience

• Strong organizational and diagnostic skills with attention to detail, accuracy and follow through

• Demonstrated ability to communicate clearly, accurately and professionally across verbal, written, and phone interactions with internal and external stakeholders

 Preferred Qualifications

• Experience with Medicare Part B documentation verification, billing and/or collections.

• Ability to make sound business decisions independently and collaboratively

• Ability to work effectively both independently and within a team

• Flexibility to adapt in a dynamic environment

• Strong organizational skills with attention to detail, accuracy and follow through

• Ability to maintain strict confidentiality in compliance with company standards and HIPAA guidelines

• Rhode Island Pharmacy Technician License (Tech II) 

• CPhT Certification by PTCB

Education

• Verifiable High School Diploma or GED required

• Associate’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 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.