At CVS Health, I manage denied medical claims by reviewing, correcting, and resubmitting them within payer guidelines. I also coordinate script write-offs and handle notifications about potentially fraudulent scripts, working with pharmacies and insurers to reverse and report claims.
I prioritize refund requests and overpayments to support contract and legal adherence with payers, including Medicare and Medicaid.
Earlier at CVS Health, I analyzed rejected script claims and worked with other teams in the Third Party Finance department to address rejection issues across the store network. I also contributed to a project identifying sources of bad debt in pharmacy receivables and building plans to address them.
At Blackstone Valley Eye Care, I worked primarily in medical billing, checking insurance eligibility, submitting claims, posting payments, and following up on invoices. My earlier pharmacy experience included supervising technicians, filling prescriptions, managing inventory, and maintaining insurance and billing information.
