Senior Pharmacy Claims & Benefit Specialist

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

Benefits offered by this job

Medical, dental, and vision coverage

Bonus eligibility and incentive plans

Comprehensive benefits package

Job summary

CVS Health is seeking a claims analyst to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. This full-time role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations.

Eligible for CVS Health bonus and comprehensive benefits. Anticipated 40-hour work week with a supportive team dedicated to improving patient experiences and

Qualifications

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

Responsibilities

• Research, review, and correct pharmacy-related claim issues for accurate benefits.
• Executes routine and non-routine business support tasks under supervision.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Identifies and reports claim overpayments, underpayments, and irregularities.
• Takes direction to execute techniques, processes, and responsibilities.

Skills

Production experience

Medical claim processing

Analytical skills

Attention to detail

Communication skills

Prioritization

DG system claims processing

Education

Associate degree or equivalent experience

Job description

CVS Health is seeking a claims analyst to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. This full-time role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations.

Eligible for CVS Health bonus and comprehensive benefits. Anticipated 40-hour work week with a supportive team dedicated to improving patient experiences and