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CVS Health Quality Assurance Analyst - Revenue Cycle in Monroeville, Pennsylvania

Job Description

The Quality Assurance Analyst assures consistent quality of Specialty Services Revenue Cycle functions in order to yield improved financial results for CVS Specialty Health. The role will be accountable for conducting quality audits specific to Specialty Accounts Receivable and partnering with training and process improvement functions to enable continuous improvement. The role will also provide information to assist in the feedback and formal education process for specialty colleagues.

  • Utilizes defined quality assurance processes to conduct audits ensuring compliance with performance standards (e.g., quality, accuracy and timeliness)

  • Reports on performance results and may provide support to supervisors in the development of action plans for staff and unit effectiveness

  • Coaches Billing, Cash and/or Collections staff on work procedures to enable immediate improvements to financial outcomes

  • Provides on-going feedback and acts as subject matter expert in addressing procedural issues

  • Utilizes thematic outcomes of quality audits to identify individual and departmental training needs

  • Partners with training function to ensure training needs are addressed

  • Identifies developing trends impacting service levels and proactively partners with process improvement team to recommend process enhancements or solutions to avoid potential service delivery problems Ensures compliance with key regulations (e.g., SOX) and internal controls; serves as shared services center point of contact for internal and external audits

  • Partners with business leadership and business enablement functions to drive a culture of continuous improvement within the shared services center

  • Provides technical and subject matter expertise relative to policies, procedures, and A/R applications/systems tools

  • Contributes to team effort by accomplishing related results and other responsibilities as assigned

Required Qualifications

One or more years experience working in Healthcare Revenue Cycle

  • One or more years experience with Microsoft Office Suite, specifically Excel

Preferred Qualifications

Pharmacy or health care experience

  • Quality Assurance experience

  • Demonstrated analytical and problem-solving skills

  • Attention to detail and accuracy

  • Strong written and verbal communication skills

  • Strong organizational skills


High School diploma/GED required; Bachelor's degree preferred

Business Overview

It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm . We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team at mailto:AdviceCounsel@cvshealth.com . Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com . For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.