Medical Claims Rework Specialist | Data-Driven & Detail-Focused

CVS Health; United States; Presencial; USD 23.000 - 43.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement options

Descripción de la vacante

CVS Health is seeking a highly motivated candidate to review and rework sensitive medical and hospital claims for our rework project department. They will work closely with the Commercial Services Operations team providing root cause analysis and precise resolution of affected claims.

The role requires strong attention to detail, analytical skills, and proficiency in Excel. You will help ensure accuracy and timely resolutions across complex cases, including plan sponsor issues and regulatory

Formación

• Minimum 1 year of experience in medical claims processing or related healthcare role.
• Strong analytical and problem-solving skills for complex claim issues.
• Ability to manage multiple priorities with quality and turnaround time in mind.
• Attention to detail and accuracy, with Excel proficiency.

Responsabilidades

• Review and rework sensitive medical and hospital claims for rework projects.
• Provide root cause analysis and precise resolution of affected claims.
• Interface with appropriate areas to ensure claims are resolved by due date.
• Support compliance and handle complex issues for provider networks.

Conocimientos

Medical claims processing

Research & problem solving

Excel basics

Multitasking

Attention to detail

Educación

High School diploma or equivalent

Descripción del empleo

CVS Health is seeking a highly motivated candidate to review and rework sensitive medical and hospital claims for our rework project department. They will work closely with the Commercial Services Operations team providing root cause analysis and precise resolution of affected claims.

The role requires strong attention to detail, analytical skills, and proficiency in Excel. You will help ensure accuracy and timely resolutions across complex cases, including plan sponsor issues and regulatory