Health Insurance Quality Champion – Claims & Service

CVS Health; Oklahoma; Hybrid; USD 25,000 - 53,000; 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 Quality Assurance professional to champion quality in claims processing and customer service, measuring the effectiveness of work processes that impact customer satisfaction, medical cost management, and operational efficiency.

You will conduct audits, partner with cross‑functional teams, and report findings with training and process improvement recommendations to senior management to drive ongoing quality and compliance.

Qualifications

• 2+ years of health insurance work experience and/or Healthcare Insurance Quality Review.
• 2+ years of experience working with diagnosis codes and medical terminology.
• Moderate to advanced knowledge of Excel (V-lookups, pivot tables, and/or formulas).

Responsibilities

• Act as a quality champion by measuring and monitoring quality and effectiveness of work processes in claim processing and customer service.
• Consult cross-functionally to influence and promote change and deliver quality service to internal and external customers.
• Perform regular quality audits to drive compliance with standards.

Skills

Health insurance experience

Diagnosis codes knowledge

Medical terminology knowledge

Education

High School Diploma or GED

Tools

Excel

Job description

CVS Health is seeking a Quality Assurance professional to champion quality in claims processing and customer service, measuring the effectiveness of work processes that impact customer satisfaction, medical cost management, and operational efficiency.

You will conduct audits, partner with cross‑functional teams, and report findings with training and process improvement recommendations to senior management to drive ongoing quality and compliance.