Health Plan Claims Specialist: Precise & Service‑Driven

CVS Health; Columbus (OH); On-site; USD 23,000 - 47,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement options

Job summary

CVS Health is seeking a detail-oriented Claim Benefit Specialist to adjudicate and resolve medical claims, contributing to member satisfaction and retention. You will be part of a team focused on accuracy, speed, and quality, with training and ongoing support to meet performance metrics.

Attendance during a 21-week training period is required; after training, overtime may be required based on business needs.

Qualifications

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

Responsibilities

• Determine coverage under a member's health plan.
• Use multiple systems to obtain and record claim information.
• Review claims to determine illness or injury.
• Identify cost management opportunities and refer follow-ups.
• Make claim payment decisions.
• Process claims to enhance satisfaction and retention.
• Meet quality and production standards.
• Support team to achieve goals.

Skills

Attention to detail

Multi-system navigation

Keyboarding speed

Education

High School Diploma or GED

Tools

Windows

Job description

CVS Health is seeking a detail-oriented Claim Benefit Specialist to adjudicate and resolve medical claims, contributing to member satisfaction and retention. You will be part of a team focused on accuracy, speed, and quality, with training and ongoing support to meet performance metrics.

Attendance during a 21-week training period is required; after training, overtime may be required based on business needs.