Impactful Benefits Claims Specialist

CVS Health; United States; Vor Ort; USD 23.000 - 39.000; Vollzeit

Benefits dieser Stelle

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement plan

Wellness programs

Zusammenfassung

CVS Health is seeking a full-time Benefits Claims Processor to review and process medical claims, verify coverage, and ensure timely reimbursements. You will determine eligibility, confirm coding accuracy, and communicate with providers and patients to resolve discrepancies.

This role emphasizes adherence to policies, data integrity, and continuous improvement in the claims process. The position requires 1+ year in customer service, strong problem solving, and the ability to handle multiple

Qualifikationen

• 1+ year working experience in a customer service environment.
• Working knowledge of problem solving and decision making skills.

Aufgaben

• Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy and adherence to policies.
• Determines eligibility and coverage based on patient plan and guidelines.
• Assesses claims for accuracy and compliance with coding, medical necessity, and documentation requirements.
• Documents claim information in the company system with codes and data elements for tracking and processing.
• Communicates with healthcare providers and patients to resolve discrepancies.
• Generates reports to identify trends and inform process improvements.

Kenntnisse

Customer service

Problem solving

Decision making

Ausbildung

High school diploma or equivalent

Jobbeschreibung

CVS Health is seeking a full-time Benefits Claims Processor to review and process medical claims, verify coverage, and ensure timely reimbursements. You will determine eligibility, confirm coding accuracy, and communicate with providers and patients to resolve discrepancies.

This role emphasizes adherence to policies, data integrity, and continuous improvement in the claims process. The position requires 1+ year in customer service, strong problem solving, and the ability to handle multiple