Senior Pharmacy Claims & Benefit Specialist

CVS Health; Connecticut; Híbrido; USD 26.000 - 54.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Descripción de la vacante

CVS Health in the United States is seeking a claims analyst to review and correct pharmacy-related claim issues to ensure accurate benefit administration, financial accuracy, and regulatory compliance.

This role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations. You will support the Claim Benefit area and collaborate with teams to identify discrepancies and maintain data integrity.

Formación

• 2+ years of experience in a production environment.
• 2+ years medical claim processing experience.
• Preferred: knowledge of pharmacy claims processing and adjustment processes.

Responsabilidades

• 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 outside specialist adjudication authority.
• Identifies and reports claim overpayments, underpayments, and irregularities.
• Takes direction to execute techniques, processes, and responsibilities.

Educación

Associate degree or equivalent experience

Descripción del empleo

CVS Health in the United States is seeking a claims analyst to review and correct pharmacy-related claim issues to ensure accurate benefit administration, financial accuracy, and regulatory compliance.

This role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations. You will support the Claim Benefit area and collaborate with teams to identify discrepancies and maintain data integrity.