Claim Benefit Specialist

CVS Health; Hartford (CT); On-site; USD 23,000 - 43,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a dedicated medical claims processor to review and rework sensitive hospital and medical claims for our rework project. You will collaborate with the Commercial Services Operations team to analyze root causes and deliver precise resolutions within deadlines.

This full-time role requires attention to detail, Excel proficiency, and the ability to manage multiple priorities in a fast-paced healthcare environment, with benefits including medical, dental, vision coverage and

Qualifications

• Minimum 1 year of experience in medical claims processing or related healthcare administrative role.
• Strong analytical and problem-solving skills.
• Ability to manage multiple priorities with quality and turnaround time.
• Proficiency in Microsoft Excel (sorting, filtering, basic data analysis).
• Ability to work in a fast-paced environment.

Responsibilities

• Review and rework sensitive, complex medical and hospital claims for the rework project department.
• Work closely with the Commercial Services Operations team to provide root cause analysis and precise resolutions.
• Ensure claims are resolved accurately and handled by the rework project due date.

Skills

Medical claims processing

Analytical thinking

Multitasking

Attention to detail

Excel proficiency

Adaptability

Education

High School diploma or equivalent

Job description

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

CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work closely with other members of the Commercial Services Operations team providing root cause analysis and precise resolution of affected claims. The candidate is responsible for ensuring the rework project claims are resolved accurately, interfaces with appropriate areas, and is handled by the rework project due date.

The candidate will serve as a medical/hospital claim processor for rework projects, compliance, and complex issues for a specific provider/network or large-scale rework projects generated as a result of plan sponsor issues, release fallout and/or legal/regulatory/compliance concerns.

Required Qualifications

• Minimum 1 year of experience in medical claims processing, healthcare billing, revenue cycle operations, or a related healthcare administrative role.
• Strong analytical and problem-solving skills with the ability to research and resolve complex claim issues.
• Proven ability to manage multiple priorities while meeting quality and turnaround time expectations.
• Strong attention to detail and commitment to accuracy.
• Proficiency in Microsoft Excel, including sorting, filtering, and basic data analysis.
• Demonstrated ability to work effectively in a fast-paced environment while adapting to changing business needs.

Preferred Qualifications

• Experience working in healthcare, insurance, claims processing, medical billing, or customer service.
• Knowledge of medical terminology, insurance benefits, or healthcare operations.
• Experience using computer systems to research and resolve customer or claim-related issues.
• Ability to work independently and collaboratively in a team environment.
• Strong organizational and time management skills.
• Demonstrated adaptability and willingness to learn new processes and systems.

Education

High School diploma or equivalent

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$17.00 - $31.30

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.

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.

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources

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

We anticipate the application window for this opening will close on: 11/14/2026

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