Claim Field Trainer: Provider Education & Denial Insights

CVS Health; Fort Myers (FL); Hybrid; USD 47,000 - 102,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

The CVS Health Claim Field Specialist will serve as the primary resource for providers in Central Florida, focusing on claim denials, education, and resolution. You will travel up to 70% of the time to meet with providers and conduct trainings, guiding education initiatives and ensuring compliance with Medicaid claim policies.

Join CVS Health to help streamline provider claims processes, develop training materials, and collaborate with cross-functional teams to improve provider satisfaction and

Qualifications

• 2+ years in medical billing and coding for claims processing and root cause analysis.
• 2+ years in provider engagement and/or relations.
• Proficient with MS Office; advanced Excel skills for data mining.
• Must reside in Central Florida and be willing to travel 70% of the time.

Responsibilities

• Educate providers on claim denials, education, and resolution.
• Develop claim trainings, bulletins, and newsletters.
• Trend provider claim disputes with grievance/appeals teams.
• Meet with providers in-person and virtually to review trends and policies.

Skills

Medical billing

Provider engagement

Communication

Data analysis

Time management

Education

High school diploma or GED

Associate’s or Bachelor’s degree

Tools

Microsoft Office

Excel

Job description

The CVS Health Claim Field Specialist will serve as the primary resource for providers in Central Florida, focusing on claim denials, education, and resolution. You will travel up to 70% of the time to meet with providers and conduct trainings, guiding education initiatives and ensuring compliance with Medicaid claim policies.

Join CVS Health to help streamline provider claims processes, develop training materials, and collaborate with cross-functional teams to improve provider satisfaction and