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Sr Coordinator Payor Relations Department Auditor
Sr Coordinator Payor Relations Department Auditor-November 2024
Monroeville
Nov 25, 2024
ABOUT CVS HEALTH
CVS Health is a healthcare innovation company. Together, we are helping people on their path to better health.
10,000+ employees
Healthcare
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About Sr Coordinator Payor Relations Department Auditor

  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 SummaryThe primary responsibilities of the Payor Relations Auditor is department auditing of system setup and configurations. The Payor Relations Auditor will conduct quality control audit assessments and conduct routine reviews. The Payor Relations Auditor will also be responsible for working with our internal auditors as well as E&Y to satisfy SOX controls. Additionally, the Payor Relations Auditor will be responsible for reviewing, researching and determining resolution of incoming Payor Relations escalations as well as providing recommendations to streamline and/or implement processes to support the department.

  Required Qualifications

  1+ years of health care insurance experience

  Proficient Microsoft Office skills - Excel, Word, PowerPoint, OneNote, and Outlook experience.

  Preferred Qualifications

  1-2 years healthcare insurance experience.

  Ability to prioritize and work independently.

  Ability to work independently.

  Strong problem solving skills.

  Ability to meet deadlines across competing priorities

  Excellent organizational and prioritization skills.

  Excellent verbal, written and communication skills.

  Exhibits good judgment when escalating issues to management.

  Experience with Pharmacy Reimbursement based pricing and associated pricing compendia

  Knowledge of Reimbursement workflow, policies and procedures preferred

  Experience with large, multi-geographic organizations and diverse culture

  EDUCATION

  Verifiable High School Diploma or GED is required.Pay Range

  The typical pay range for this role is:

  $18.50 - $35.29

  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. 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

  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.

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