Inbound Patient Account Services Coordinator (Remote)

📋 Description

• • Serve as the first point of contact for patients who have questions about CVS Specialty billing, insurance claims, and payment plans—turning confusion into clarity and anxiety into confidence.
• • Master the end-to-end CVS Specialty revenue cycle so you can explain, in plain language, how a prescription becomes a shipment, how benefits are verified, and how balances are calculated.
• • Field 40–60 inbound calls per day from patients, caregivers, and providers, documenting every interaction in Epic/RevCycle while maintaining 95 %+ accuracy and adhering to HIPAA and PCI standards.
• • Investigate and resolve complex billing discrepancies—duplicate charges, denied claims, prior-authorization lapses—by partnering with insurance payers, prior-auth teams, and pharmacy operations.
• • Proactively identify trends (e.g., recurring copay errors, payer policy changes) and escalate them to Leadership with data-driven recommendations that can prevent thousands of future patient issues.
• • Build individualized payment solutions: set up zero-interest payment plans, enroll patients in manufacturer copay cards, and screen for Medicaid or foundation grants that reduce out-of-pocket costs.
• • Deliver empathy at scale—listen for emotional cues, de-escalate frustration, and celebrate small wins with patients who may be managing chronic or life-threatening conditions.
• • Meet or exceed call-center KPIs: average handle time ≤ 9 minutes, first-call resolution ≥ 80 %, quality-assurance score ≥ 90 %, and schedule adherence within 2 minutes of shift start.
• • Leverage Salesforce Service Cloud, Microsoft Teams, and Excel pivot tables to track case status, share knowledge articles, and collaborate with colleagues across pharmacy, nursing, and payer relations.
• • Rotate through an 8 a.m.–8 p.m. EST window Monday–Friday (your 8-hour shift will be set at hire) and remain flexible for quarterly overtime surges during Medicare open enrollment.
• • Contribute to a remote-first culture that values inclusion, continuous learning, and “Putting People First” by joining daily huddles, peer-shadowing sessions, and monthly patient-experience roundtables.
• • After 90 days, mentor new hires, co-author knowledge-base articles, and pilot AI chatbot scripts that reduce routine call volume by 15 %, freeing you for higher-value patient advocacy.