Senior Pharmacy Claims & Benefit Analyst

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

Job summary

CVS Health is seeking a claims processor to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and compliance. The role emphasizes analytical skills, attention to detail, and the ability to work independently to meet productivity and quality targets.

The position offers a full-time schedule with standard weekly hours and a comprehensive benefits package. Base pay ranges are reflective of experience, geography, and performance, with eligibility

Qualifications

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

Responsibilities

• Executes routine and non-routine business support tasks for the Claim Benefit area under limited supervision.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise.
• Identifies and reports claim overpayments, underpayments, and any irregularities.
• Takes direction to execute techniques, processes, and responsibilities.

Skills

Claims processing

Attention to detail

Education

Associate degree

Job description

CVS Health is seeking a claims processor to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and compliance. The role emphasizes analytical skills, attention to detail, and the ability to work independently to meet productivity and quality targets.

The position offers a full-time schedule with standard weekly hours and a comprehensive benefits package. Base pay ranges are reflective of experience, geography, and performance, with eligibility