Health Plan Claims Specialist

CVS Health; Annapolis (MD); On-site; USD 23,000 - 47,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement savings

Job summary

CVS Health is hiring for a Claim Benefit Specialist role based in the United States. You will review and adjudicate medical claims, aiming to enhance member satisfaction by providing accurate, timely resolutions and supporting overall claim service quality.

The position requires attention to detail, ability to work in a team, and capacity to use multiple computer systems. Attendance during a 21-week training period is required, with overtime possible after training.

Qualifications

• Experience in a quality and production environment.
• Attention to detail.
• 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

Attention to detail

Multitasking

Computer applications

Education

High School Diploma or GED

Associate's Degree

Job description

CVS Health is hiring for a Claim Benefit Specialist role based in the United States. You will review and adjudicate medical claims, aiming to enhance member satisfaction by providing accurate, timely resolutions and supporting overall claim service quality.

The position requires attention to detail, ability to work in a team, and capacity to use multiple computer systems. Attendance during a 21-week training period is required, with overtime possible after training.