Flexible Schedule Claims Benefit Specialist

Socket.dev; Tennessee; On-site; USD 23,000 - 36,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health is seeking a Claims Benefit Specialist to support health benefit claims processing. The role includes training for 20 weeks virtually, handling claims adjudication, eligibility verification, and data accuracy in a fast-paced environment.

It emphasizes attention to medical necessity guidelines, coding accuracy, and proactive communication with providers and patients. A 40-hour week and a comprehensive benefits package are provided.

Qualifications

• 1–2 years of customer service experience required.
• Strong teamwork and organizational skills.
• Excellent communication and time management abilities.

Responsibilities

• Review and adjudicate claims in line with processing guidelines.
• Verify eligibility and coverage for benefits based on plans.
• Communicate with providers and patients to resolve discrepancies.
• Document claim data accurately in the system and code using guidelines.
• Ensure compliance with regulatory requirements and company policies.

Skills

Customer service

Teamwork

Communication skills

Time management

Education

High School diploma, GED or equivalent

Job description

CVS Health is seeking a Claims Benefit Specialist to support health benefit claims processing. The role includes training for 20 weeks virtually, handling claims adjudication, eligibility verification, and data accuracy in a fast-paced environment.

It emphasizes attention to medical necessity guidelines, coding accuracy, and proactive communication with providers and patients. A 40-hour week and a comprehensive benefits package are provided.