Billing Premium Consultant

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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.

Position Summary Customer Service is the important first-line of contact with customers, setting the tone for how members, doctors and plan sponsor groups view our company. It provides members with the right information at the right time to help them make better decisions about their health and health care.

Process accurate and timely eligibility into Aetna Systems utilizing Aetna policy guidelines and in accordance with key performance measures and first claim/first call resolution. Provide Plan Sponsors with accurate bills and members with timely and accurate ID cards and audit cert lists. Improvement of financial results by reducing losses associated with non-payment. Ensures collected reconciled dollars are allocated across benefits and structure.

Provide Plan Sponsors with accurate bills and ensure dues are finalized and money is collected and allocated across benefits and structure.

Monitors, researches, and resolves collection of outstanding premium, overdue accounts, or revenue adjustment issues and reports corrections or coordinates collection and cancellation of overdue customers in accordance with pre-established market segment process. Ensures all manual adjustments, refunds, and write-offs are appropriately submitted, adhering to policy guidelines. Validates and updates Self Insured Revenue forecasting information and trends. Coordinates validation of eligibility. Ensures that remittances are posted accurately across various benefits and account structure and reconciles customer remittances.

Consults with internal/external customers to identify accurate account structure, billing format method and payment arrangements to meets customer's expectations. May negotiate and communicate change for non-standard products and/or services; evaluates customer billing requirements, customer payment arrangements and history to deliver a timely and technically accurate product. Researches, resolves and responds to product inquiries, i.e., revenue adjustment issues, from internal and external customers, e.g., Plan Sponsor, Member Services, third party vendor.

Ensures that legislation and compliance has been properly adhered to with regard to Plan Sponsor and/or member activity. Utilizes and interprets on line resources to understand customer's account structure and benefits. May assist with the development of such resources. Monitors and manages internal installation process, i.e., reports, to identify issues and ensures timely and accurate resolution to meet business goals and constituents expectations.

Required Qualifications

Ability to analyze financial information and reports. Ability to prioritize tasks/work effectively. Strong verbal and written communication skills. Well organized. Math and accounting skills. Problem solving skills. Attention to detail and accuracy.

Preferred Qualifications

Financial experience a plus

Education HS Diploma

Pay Range

The typical pay range for this role is:

$17.00 - $28.45

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. 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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 03/29/2024

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.