Remote Medical Claims Analyst — Health Payments Expert

CVS Health; Bismarck (ND); Remote; USD 25,000 - 58,000; Full time

Job summary

CVS Health is seeking a remote Claims Processor to support initial review and triage of health claims. The role emphasizes accurate eligibility checks, coverage determinations, and preparing authorizations for medical review.

A strong customer-service mindset and secure handling of patient information are essential. The position requires 2–4 years of relevant experience, familiarity with medical terminology, and proficiency in Microsoft Excel and Word.

Qualifications

• 2–4 years experience as a medical assistant, office assistant or claim processor.
• Familiar with basic medical terminology and concepts used in care.
• Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.

Responsibilities

• Review and triage claims assigned for review.
• Determine coverage and verify eligibility; identify and redirect misdirects.
• Prepare authorization in the system; triage cases to medical staff for review.
• Maintain documentation meeting regulatory, risk management, and accreditation requirements.
• Protect confidentiality of member information per CVS Health policies.
• Assist in research and resolution of claims payment issues.

Skills

Communication

Organizational

Medical terminology

Customer service

Education

High School Diploma or GED

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health is seeking a remote Claims Processor to support initial review and triage of health claims. The role emphasizes accurate eligibility checks, coverage determinations, and preparing authorizations for medical review.

A strong customer-service mindset and secure handling of patient information are essential. The position requires 2–4 years of relevant experience, familiarity with medical terminology, and proficiency in Microsoft Excel and Word.