Senior Pharmacy Claims & Benefits Specialist

CVS Health; Virginia; Ibrido; USD 25.000 - 53.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Descrizione del lavoro

CVS Health in Virginia is seeking a claims analyst to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. The role requires strong analytical skills and the ability to work independently to meet productivity and quality expectations.

The position involves processing routine and non-routine tasks for the Claim Benefit area, following protocols, and identifying claim overpayments, underpayments, and irregularities while

Competenze

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

Mansioni

• Research, review, and correct pharmacy-related claim issues to ensure accurate benefit administration and compliance.
• 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 irregularities.
• Take direction to execute techniques, processes, and responsibilities.

Conoscenze

Production environment experience

Medical claim processing experience

Analytical skills

Attention to detail

Data interpretation

Verbal and written communication

Independent work ability

Formazione

Associate degree or equivalent experience

Descrizione del lavoro

CVS Health in Virginia is seeking a claims analyst to research, review, and correct pharmacy-related claim issues, ensuring accurate benefit administration and regulatory compliance. The role requires strong analytical skills and the ability to work independently to meet productivity and quality expectations.

The position involves processing routine and non-routine tasks for the Claim Benefit area, following protocols, and identifying claim overpayments, underpayments, and irregularities while