Senior Pharmacy Claim & Benefit Specialist

CVS Health; Alabama; Hybrid; USD 25,000 - 53,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a claims processing professional to research, review, and correct pharmacy-related claim issues. You will support the Claim Benefit area, follow established protocols, and identify discrepancies to ensure accurate benefits and compliance.

The role emphasizes attention to detail, independent work, and timely problem resolution. The position is full-time with a typical 40-hour work week and eligibility for CVS Health bonus programs.

Qualifications

• 2+ experience in a production environment.
• 2+ years medical claim processing experience.
• Knowledge of claims processing helpful.

Responsibilities

• Research, review, and correct pharmacy-related claim issues to ensure accurate benefit administration.
• Execute routine and non-routine business support tasks for the Claim Benefit area under limited supervision.
• Identify and report claim overpayments, underpayments and irregularities.
• Follow area protocols and policies to provide effective and timely support.
• Take direction to execute specified techniques and responsibilities.

Skills

Analytical skills

Attention to detail

Communication skills

Prioritize work

Education

Associate degree or equivalent experience

Job description

CVS Health is seeking a claims processing professional to research, review, and correct pharmacy-related claim issues. You will support the Claim Benefit area, follow established protocols, and identify discrepancies to ensure accurate benefits and compliance.

The role emphasizes attention to detail, independent work, and timely problem resolution. The position is full-time with a typical 40-hour work week and eligibility for CVS Health bonus programs.