Senior Medical Claims & Benefit Specialist

CVS Health; Boston (MA); Vor Ort; USD 25.000 - 58.000; Vollzeit

Benefits dieser Stelle

Medical, dental, and vision coverage

Paid time off

Retirement savings

Wellness programs

Zusammenfassung

CVS Health in Boston, MA is seeking a claims processor to review and adjudicate various medical and RX claims, process refunds, and handle related inquiries. The role requires applying medical necessity guidelines and ensuring accurate payments.

The position offers full-time hours with comprehensive benefits, and eligibility for CVS Health bonus programs. Strong attention to detail and regulatory compliance are essential.

Qualifikationen

• 2+ years of medical claim processing experience.
• Experience working in a production environment.
• Ability to manage multiple assignments accurately and efficiently.
• Strong communication, organizational, and interpersonal skills.

Aufgaben

• Review and adjudicate complex medical claims per guidelines.
• Process provider refunds and returned checks.
• Handle customer service inquiries related to claims.
• Apply medical necessity guidelines and determine coverage.
• Ensure compliance and accurate payments.

Kenntnisse

Claim processing

Production environment

Multitasking

Communication

Organizational skills

Ausbildung

High School Diploma or GED

Associate degree preferred

Jobbeschreibung

CVS Health in Boston, MA is seeking a claims processor to review and adjudicate various medical and RX claims, process refunds, and handle related inquiries. The role requires applying medical necessity guidelines and ensuring accurate payments.

The position offers full-time hours with comprehensive benefits, and eligibility for CVS Health bonus programs. Strong attention to detail and regulatory compliance are essential.