Senior Pharmacy Claims & Benefits Specialist

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health in Pennsylvania is seeking a Pharmacy Claims Processor to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. The role requires strong analytical skills, attention to detail, and the ability to work independently while maintaining productivity and quality.

The position is full-time, 40 hours per week, with a pay range of $18.50 to $38.82 per hour and a comprehensive benefits package including medical, dental,

Qualifications

• 2+ years of production environment experience.
• 2+ years of medical claim processing experience.
• Associate degree or equivalent experience.

Responsibilities

• Research, review, and correct pharmacy-related claim issues to ensure accurate benefit administration.
• 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.

Skills

Production experience

Medical claim processing

Education

Associate degree

Tools

DG system

Job description

CVS Health in Pennsylvania is seeking a Pharmacy Claims Processor to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. The role requires strong analytical skills, attention to detail, and the ability to work independently while maintaining productivity and quality.

The position is full-time, 40 hours per week, with a pay range of $18.50 to $38.82 per hour and a comprehensive benefits package including medical, dental,