Claims Benefit Specialist — Fast, Precise Claims

CVS Health; Columbia (SC); On-site; USD 23,000 - 47,000; Full time

Benefits offered by this job

Medical insurance

Dental & vision

Paid time off

Retirement plans

Job summary

CVS Health is seeking a detail‑oriented claims processing professional to review and adjudicate medical claims in line with processing guidelines. This role emphasizes accuracy, customer service, and adherence to quality metrics.

Training spans about 21 weeks, with potential overtime after completion based on business needs. The position requires strong communication, teamwork, and the ability to navigate multiple computer systems to document claim information and decisions.

Qualifications

• Experience in a quality and production environment.
• Attention to detail and accuracy.
• Ability to use multiple computer applications at one time.

Responsibilities

• Determine and understand the coverage provided under a member's health plan.
• Efficiently use multiple systems and screens to obtain and record claim information.
• Review claims information to determine the nature of a member's illness or injury.
• Identify claim cost management opportunities and refer claims for follow up.
• Make claim payment decisions.
• Process claims accurately to enhance customer satisfaction and retention.
• Process claims within quality and production standards.
• Assist team members in support of achieving team, office, regional, and national goals.

Skills

Quality/Production experience

Attention to detail

Multi-app computer use

Education

High School Diploma or GED

Tools

Windows navigation

Job description

CVS Health is seeking a detail‑oriented claims processing professional to review and adjudicate medical claims in line with processing guidelines. This role emphasizes accuracy, customer service, and adherence to quality metrics.

Training spans about 21 weeks, with potential overtime after completion based on business needs. The position requires strong communication, teamwork, and the ability to navigate multiple computer systems to document claim information and decisions.