Senior Coordinator of Accounting Employee

CVS Health

Employee

TELECOMMUTE – High Point, NC Candidates need to be able to work in the City or State specified

1/11/23

Job Description

Title:Senior Coordinator of Accounting

High Point NC

Category:Aetna

Job Type:Fully remote

Salary:18.50 – 34.60 /hour

Job Description:

This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and validate claims for overpayment.

The ideal candidate will be able to work independently and with others to review claims tied to different overpayment projects in the Overpayment Tracking System (OPT), revalidate overpayment files, send claims to rework and verify accuracy when needed. The position requires strong verbal and written communication skills and a comprehensive understanding of ACAS claims overpayment scenarios.

This position will require the candidate to manage each plan sponsor s AR. This includes making collection calls, handling provider and member disputes which includes revalidation of overpayment records, setting up and tracking installment payments and minus debit escalations. The candidate will need to be able to identify when collection attempts need to include Network involvement. The candidate will also need to successfully leverage daily, monthly and quarterly reports to ensure collection progress.

These skills will be utilized to meet plan sponsor Performance Guarantees and avoid customer abrasion and penalty payments.

In addition, the candidate should be able to serve as an OPT SME, handle OPT adjustment reviews and manage other production activities using WEBI reports.

Responsibilities include:

Review concepts and instructions provided by various constituents targeting overpaid claims

Follow validation instructions provided by our constituents to properly review ACAS claims for overpayment

Utilize ASD or GPS for claim review

Utilize SCM where appropriate for claim review

Review provider contracts in accordance with project concepts and validation instructions in order to identify overpaid claims

Make collection calls to members and providers, coordinating with collection vendors and other internal collection teams.

Refer claims in the ACAS overpayment system to ASD to rework claims after validating as overpaid

Review/approve/reject OPT adjustment requests

Review OPT issues to identify possible solutions before presenting them on the OPT Hotline Call

Review replacement check and reverse minus debit requests for approval

Pay Range

The typical pay range for this role is:

Minimum: 18.50

Maximum: 34.60

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

2 years experienceworking with ASD or GPS, SCM, ECHS, and Claims X Ten

Knowledge of ACAS claims systems

Familiarity with e.Policies

Preferred Qualifications

Previous experience with overpayments on the ACAS platform

Project experience working with providers on overpayment issues

Education

Bachelor degreein Accounting, Finance or a closely-related field, or an equivalent combination of formal education and recent and related experience

Accounting & Finance , Business Development , Insurance , Insurance Claims

High Point, NC Candidates need to be able to work in the City or State specified