Medical Claim Analyst

Colorado Psychiatric; Colorado; Presencial; USD 25.000 - 53.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Bonus eligibility

Descripción de la vacante

CVS Health in Colorado is seeking a detail-oriented Medical Claims Support specialist to inspect and provide accurate claim information, respond to benefit inquiries, and help optimize costs.

You will administer policies for medical cost management, coordinate claim adjudication support, and uphold customer service standards. A high school diploma is required, and the position offers full-time hours and comprehensive benefits.

Formación

• Performs routine and non-routine tasks in Medical Claims under supervision.
• Follows protocols and policies to provide timely support.
• Reviews provider billing to identify savings opportunities.
• Participates in claim billing training for processors.
• Tests automated review programs.

Responsabilidades

• Inspects and provides accurate claim information to support savings optimization.
• Responds to customers on benefit inquiries.
• Maintains customer service standards.
• Coordinates support for claim adjudication.

Conocimientos

Problem solving

Decision making

Customer service

Training programs

Attention to detail

Educación

High school diploma or equivalent

Descripción del empleo

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

Inspects and provides accurate claim information to support savings optimization for claims. Responds to customers on benefit inquiries. Maintains customer service standards. Administers policies and procedures for medical cost management. Coordinates support functions for claim adjudication.

Required Qualifications

• Executes both routine and non-routine business support tasks for the Medical Claims area under limited supervision, referring deviations from standard practices to managers.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Reviews provider billing practices to identify trends and cost savings opportunities.
• Conducts training programs related to claim billing appropriateness and health plan guidelines for claim processors.
• Tests automated code review programs.
• Takes direction to execute techniques, processes, and responsibilities

Preferred Qualifications

• Working knowledge of problem solving and decision making skills
• 5+ years work experience

Education

High school diploma or equivalent required.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$18.50 - $38.82

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/22/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.