Medical Claims Rework & Resolution Specialist

CVS Health; Hartford (CT); On-site; USD 23,000 - 43,000; 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 dedicated medical claims processor to review and rework sensitive hospital and medical claims for our rework project. You will collaborate with the Commercial Services Operations team to analyze root causes and deliver precise resolutions within deadlines.

This full-time role requires attention to detail, Excel proficiency, and the ability to manage multiple priorities in a fast-paced healthcare environment, with benefits including medical, dental, vision coverage and

Qualifications

• Minimum 1 year of experience in medical claims processing or related healthcare administrative role.
• Strong analytical and problem-solving skills.
• Ability to manage multiple priorities with quality and turnaround time.
• Proficiency in Microsoft Excel (sorting, filtering, basic data analysis).
• Ability to work in a fast-paced environment.

Responsibilities

• Review and rework sensitive, complex medical and hospital claims for the rework project department.
• Work closely with the Commercial Services Operations team to provide root cause analysis and precise resolutions.
• Ensure claims are resolved accurately and handled by the rework project due date.

Skills

Medical claims processing

Analytical thinking

Multitasking

Attention to detail

Excel proficiency

Adaptability

Education

High School diploma or equivalent

Job description

CVS Health is seeking a dedicated medical claims processor to review and rework sensitive hospital and medical claims for our rework project. You will collaborate with the Commercial Services Operations team to analyze root causes and deliver precise resolutions within deadlines.

This full-time role requires attention to detail, Excel proficiency, and the ability to manage multiple priorities in a fast-paced healthcare environment, with benefits including medical, dental, vision coverage and