Senior Billing Consultant, Operations

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

The Plan Sponsor Services Team is looking for a Sr Billing Consultant with business and technical knowledge to join our team. This role is responsible for Bill Set-Up in the Enterprise Billing System (EBS) and coding and updating Aetna’s Billing and Member system AAS (Aetna, Inc.’s Administrative System) for ID cards in compliance with organizational policy guidelines for new, renewing, and existing business supporting the generation of timely and accurate customer invoices and member ID cards, and address system pends and ID card errors. You will work in a highly collaborative environment with Implementation Management, Account Management, Plan Sponsors & Brokers, and other internal partners with a clear focus on customers and members.

• Code the fully insured premium or the self-insured administration rates, program fees, and commissions (if applicable), in the Enterprise Billing Data Setup system, referred to as EBS, which allows for the successful generation of the customer�s monthly invoice.
  
• Complete AAS screen coding and data entry requirements related to the systems processes impacting the generation and release of member ID cards.
  
• Address system pends and ID card fatal errors, making coding corrections to generate timely and accurate ID cards.
  
• Within assigned group of plan sponsors, proactively evaluates complex and/or high visibility ID card risks and recommends appropriate measures to manage and mitigate risks to accurate ID card delivery.
  
• Gather, interpret, and define ID card requirements for new and renewing plan sponsors.
  
• Manage the Clarity (ID Card Vendor) processes, including placing and managing ID Card holds, pulling ID card samples for Quality review and releasing cards from the hold when applicable.
  
• Order ID cards at a group level upon request from Implementation Managers.
  
• Confirm accuracy of ID cards before sharing with customer or account management team for final approval.
  
• Provide back-up support to other Sr Billing Consultants depending on workload and high priority projects to ensure timely delivery of services.
  
• Review and resolve issues and inquiries from internal and external customers, ensuring timely and satisfactory resolutions.
  
• Mentor new or less experienced Sr. Billing Consultants. Assists in the training and development of new or less experienced staff.
  

• 1+ years of relevant work experience in health insurance operations
  
• Data analytic, problem-solving, and critical thinking skills
  
• Customer service orientation with strong interpersonal and communication skills
  
• Willingness to work in a fast-paced and dynamic working environment
  
• Strong organizational & time management skills
  
• Self-motivated with the ability to embrace change
  
• Ability to work independently, with minimal supervision and prioritize work effectively
  
• Work with high degree of accuracy
  

• 3+ years of relevant work experience in health insurance operations
  
• Knowledge of ID Card Policies and Procedures
  
• Knowledge of CCI ad AAS Coding processing experience
  
• Working knowledge of MS Excel
  

• High School Diploma or General Equivalent Development (GED)
  

40

Full time

Shift Flexibility:

Monday: -

Tuesday: -

Wednesday: -

Thursday: -

Friday: -

Saturday: -

Sunday: -

Weekend Shift Frequency:

The typical pay range for this role is:

$18.50 - $42.35

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
  

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 08/11/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.