Member Billing Senior Coordinator, Financial Operations

Member Billing Senior Coordinator

We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

Position Summary:

The Member Billing Senior Coordinator supports accurate, timely, and compliant processing of member premium billing across PBM Financial Operations. The role covers autopay enrollment, payment posting and exceptions, member inquiries, statements, payment plans, refunds, and past-due and disenrollment activity. The Senior Coordinator works closely with teammates, internal partners, and external vendors to ensure payments are posted accurately, within standard turnaround times, and in line with Centers for Medicare & Medicaid Services (CMS) Medicare Part D requirements.

This role supports functions across the Member Billing Center of Excellence (COE), starting with core payment work and progressing into more advanced functions such as payment quality reviews, reconciliations, refund processing, and CMS-regulated dunning cycles. The Senior Coordinator partners with Customer Care, Grievance, Account Management, Enrollment, Finance, Information Technology (IT), and vendor partners to resolve complex issues.

This role offers opportunities for professional growth within Financial Operations and is well suited for candidates with a finance or accounting background who are comfortable adopting new technologies, including AI-enabled tools.

Location:

This is a hybrid role that requires on-site presence up to 3 days per week at our Scottsdale, AZ office for training and eventually 1 day per month. Candidates must reside in Arizona within commuting distance of Scottsdale.

Role Overview:

This role requires strong attention to detail, sound judgment, and clear, concise communication. The Senior Coordinator will manage multiple priorities in a fast-paced, deadline-driven environment while following established procedures, documenting work clearly, and escalating issues appropriately. The team uses Microsoft 365 Copilot and other AI-enabled tools to support research, data analysis, and communication, and the Senior Coordinator is expected to use these tools effectively in daily work.

Key Responsibilities

Member Premium Support

• Enroll members in automatic payments, including Social Security Administration (SSA) and Railroad Retirement Board (RRB) premium withholding, recurring Electronic Funds Transfer (EFT), and Recurring Credit Card (RCD), and confirm accurate setup and posting.
• Research and resolve member inquiries, balance disputes, and enrollment-related billing issues within standard turnaround times.
• Process member statement and invoice requests, and manage payment plans from setup through completion.
• Review and resolve incoming member correspondence and escalated inquiries, including grievances.

Payments and Quality Controls

• Resolve payment exceptions, including unmatched, misapplied, missing, and returned payments, and document all actions in the system of record.
• Perform quality reviews of vendor-processed payments, including lockbox checks and electronic and phone payments, to confirm posting to the correct member account.
• Help reconcile SSA and RRB premium withholding. This includes researching mismatches, resolving withholding that has fallen out to direct billing, and making sure member credits are posted.

Billing, Dunning, and Refunds

• Support the dunning and disenrollment cycle for failure to pay premiums in accordance with CMS guidance, including past-due notices, required grace periods, and disenrollment notices.
• Review and process reinstatement requests for members whose nonpayment was due to circumstances outside their control, in accordance with CMS guidance.
• Support the weekly refund process to ensure refunds are issued within CMS timelines.
• Assist with monthly invoice proof reviews, member letter validations, and data validations.

Reporting and Continuous Improvement

• Contribute to daily and monthly operational metrics, identify trends and recurring issues, and recommend process improvements.
• Draft clear, concise communications, and create work instructions and job aids using Microsoft 365 tools.

Required Qualifications

• 1 or more years of professional experience in finance, accounting, billing operations, or a related field

Preferred Qualifications

• Proficiency in Microsoft 365, including Excel, Word, Outlook, PowerPoint, Teams, and SharePoint
• Hands-on experience with Microsoft 365 Copilot and generative AI, including writing effective prompts, validating output for accuracy, and building or using Copilot agents in Microsoft Copilot Studio
• Experience analyzing large data sets to identify trends, errors, or root causes
• Experience automating manual processes or implementing a process improvement with a measurable result, such as time saved or errors reduced
• Familiarity with SAP, Salesforce, Compass, or FACETS (Cognizant)
• Background in accounts receivable, payment posting, billing, or reconciliation

Education

• High School Diploma or GED required
• Bachelor's degree in Finance, Accounting, Information Technology, or a related field preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full?time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well?being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.