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Claim Benefit Specialist

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States, Work At Home

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Category:
Customer Service

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Contract Type:
Employment contract

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Salary:

17.00 - 28.46 USD / Hour

Job Description:

Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the opportunity to enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims. You will be a key link in providing our customers with prompt, efficient, high quality claim service.

Job Responsibility:

  • Reviews and adjudicates claims in accordance with claim processing guidelines
  • Determine and understand the coverage provided under a member's health plan
  • Efficiently use multiple systems and screens to obtain and record claim information
  • Review claims information to determine the nature of a member's illness or injury
  • Identify claim cost management opportunities and refer claims for follow up
  • Make claim payment decisions
  • Process claims accurately to enhance customer satisfaction and retention
  • Process claims within quality and production standards
  • Assist team members in support of achieving team, office, regional, and national goals

Requirements:

  • Experience in a quality and production environment
  • Attention to detail
  • Ability to use multiple computer applications at one time
  • Claim processing experience
  • High School diploma or G.E.D.

Nice to have:

  • Associates Degree
  • Prior medical claim processing experience
  • Detail oriented
  • Exceptional analytical skills
  • Accurate and fast keyboarding skills
  • Advanced computer navigation and knowledge in Windows environment
  • Effective verbal and written communication skills
  • Ability to adapt quickly and willingly to change
  • Positive, willing attitude
What we offer:
  • Affordable medical plan options
  • 401(k) plan with matching company contributions
  • Employee stock purchase plan
  • Wellness screenings
  • Tobacco cessation programs
  • Weight management programs
  • Confidential counseling
  • Financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
August 21, 2025

Expiration:
September 19, 2025

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:
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