Senior Pharmacy Claims Benefit Specialist

CVS Health; Rhode Island; 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 detail-oriented claims specialist to research and correct pharmacy-related issues, ensuring accurate benefits and compliance. You will execute routine tasks in the Claim Benefit area under supervision and report any deviations to management.

The role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations.

Qualifications

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

Responsibilities

• Research, review, and correct pharmacy-related claim issues.
• Ensure accurate benefit administration and regulatory compliance.
• Execute routine and non-routine business support tasks in Claims.
• Follow area protocols and policies for timely support.
• Identify and report claim overpayments, underpayments, and irregularities.

Skills

Attention to detail

Analytical thinking

Problem solving

Written communication

Verbal communication

Multi-tasking

Independent work

Education

Associate degree or equivalent

Tools

DG system claims processing

Job description

CVS Health is seeking a detail-oriented claims specialist to research and correct pharmacy-related issues, ensuring accurate benefits and compliance. You will execute routine tasks in the Claim Benefit area under supervision and report any deviations to management.

The role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations.