Senior Pharmacy Claims & Benefits Specialist

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

Vantaggi offerti da questo lavoro

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Descrizione del lavoro

CVS Health in the United States is seeking a Pharmacy Claims Analyst to research, review, and correct pharmacy-related claim issues to ensure accurate benefit administration, financial accuracy, and regulatory compliance. The role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations.

This full-time role offers 40 hours weekly, a pay range of $18.50–$38.82 per hour, and a comprehensive benefits package

Competenze

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

Mansioni

• Executes routine and non-routine business support tasks for the Claim Benefit area under limited supervision, referring deviations from standard practices to managers.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise.
• Identifies and reports claim overpayments, underpayments, and any other irregularities.
• Takes direction to execute techniques, processes, and responsibilities.

Conoscenze

Analytical skills

Attention to detail

Problem solving

Data interpretation

Written and verbal communication

Multi-tasking

DG system claims processing

Formazione

Associate degree or equivalent experience

Descrizione del lavoro

CVS Health in the United States is seeking a Pharmacy Claims Analyst to research, review, and correct pharmacy-related claim issues to ensure accurate benefit administration, financial accuracy, and regulatory compliance. The role requires strong analytical skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations.

This full-time role offers 40 hours weekly, a pay range of $18.50–$38.82 per hour, and a comprehensive benefits package