Senior Pharmacy Claim & Benefit Specialist

CVS Health; Arkansas; Hybride; USD 25 000 - 53 000; Plein temps

Résumé du poste

CVS Health is seeking a detail-oriented claims processor to research, review, and correct pharmacy-related claim issues. The role supports the Claim Benefit area, ensuring accurate benefit administration and regulatory compliance while maintaining productivity and quality expectations.

The ideal candidate has 2+ years in medical claim processing and operates with strong analytical and communication skills in a fast-paced environment.

Qualifications

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

Responsabilités

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

Connaissances

Analytical skills

Attention to detail

Communication skills

Formation

Associate degree

Outils

DG system claims processing

Description du poste

CVS Health is seeking a detail-oriented claims processor to research, review, and correct pharmacy-related claim issues. The role supports the Claim Benefit area, ensuring accurate benefit administration and regulatory compliance while maintaining productivity and quality expectations.

The ideal candidate has 2+ years in medical claim processing and operates with strong analytical and communication skills in a fast-paced environment.