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Claim Benefit Specialist

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States

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Category:
Customer Service

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Contract Type:
Not provided

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Salary:

17.00 - 34.15 USD / Hour
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Job Description:

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

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
  • Associate’s degree preferred
  • High School diploma required

Nice to have:

  • Detail oriented
  • Exceptional analytical skills
  • Accurate and fast keyboarding skills
  • Advanced computer navigation and knowledge and experience in a Windows environment
  • Effective verbal and written communication skills
  • Ability to adapt quickly and willingly to change
  • Positive, willing attitude
  • Prior medical claim processing experience
What we offer:
  • Affordable medical plan options
  • 401(k) plan with matching company contributions
  • Employee stock purchase plan
  • No-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and 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 05, 2025

Expiration:
August 22, 2025

Employment Type:
Fulltime
Work Type:
Remote work
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