Remote Medical Claims Triage & Review Analyst

CVS Health; North Dakota; Hybrid; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Claims Processor to review and triage medical claims, verify eligibility, determine coverage, and prepare authorizations for medical staff. The role emphasizes accurate documentation, regulatory compliance, and HIPAA adherence while supporting timely claim resolutions.

With 40 hours weekly, the position offers a competitive hourly pay range and full benefits. Remote work is required within the state of North Dakota, with provided equipment and a secure home office

Qualifications

• 2-4 years experience as a medical assistant, office assistant or claim processor.
• CEC/GPS or MedCompass education; High School Diploma or G.E.D.

Responsibilities

• Perform initial review and triage of claims for review.
• Determine coverage and verify member eligibility.
• Prepare authorization in the system and triage to medical staff.
• Maintain documentation meeting regulatory and risk management standards.
• Assist in research and resolution of claims payment issues.

Skills

Communication

Telephonic skills

Organization

Education

High School Diploma or GED

Tools

Excel

Microsoft Word

Office 365

Job description

CVS Health is seeking a Claims Processor to review and triage medical claims, verify eligibility, determine coverage, and prepare authorizations for medical staff. The role emphasizes accurate documentation, regulatory compliance, and HIPAA adherence while supporting timely claim resolutions.

With 40 hours weekly, the position offers a competitive hourly pay range and full benefits. Remote work is required within the state of North Dakota, with provided equipment and a secure home office