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CVS Health Revenue Qualifying Representative in Columbia, South Carolina

Job Description

This position is responsible for gathering and entering information related to the payer status of patients from the facility, or from the responsible party. Responsibilities:• Ensure that census paperwork is received from the Nursing facility.• Ensure that the census is entered into the operating system accurately and is valid coverage.• Review paperwork and verify completeness and of intake process focusing on payer verification and selection.• Ensure effective coordination and communication between the local pharmacy and the Central Billing Center. • Ensure the smooth dissemination of information relative to Revenue Management to the pharmacy/site and Omnicare customers.• Work Medicaid Pending reports from i-Astral and the operating system to ensure timely application of Medicaid coverage.• Improve account identification on Medicaid Application Pending (MAP).• Work and partner with other internal departments to resolve issues.• Participate in training session or conference calls to further C2W ADT management knowledge• C2W ADT Workflow grid is cleared daily for all assigned facilities• Follow all applicable government regulations including HIPAA.• Participate in projects and/or meeting as designated by management.• Other duties as assigned; job duties may vary by location.

Pay Range

The typical pay range for this role is:

Minimum: 17.00

Maximum: 27.90

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• High school diploma or equivalent. • Basic knowledge of insurance procedures • Ability to work in a fast paced, rapidly changing environment. • Excellent verbal and written communication as well as listening skills. • Intermediate computer and typing skills.

Preferred Qualifications

• Healthcare Industry Experience• Minimum of 1 – 3 years of experience working in an office/business setting• Prescription third party claims management experience• 6 -12 months of long term care pharmacy billing experience


• High school diploma or equivalent.

Business Overview

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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. 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.