Claim Benefit Specialist Job at CVS Health (Work at Home)

Senior Employee Benefits Specialist

Allied Universal® is hiring a Senior Benefits Specialist. The Senior Benefits Sp...

Location

United States , Irvine

Salary:

24.00 - 28.00 USD / Hour

Allied Universal®

Expiration Date

Until further notice

Requirements

High school diploma or equivalent (e.g., GED)
Minimum of four (4) years of benefits administrative experience in a fast-paced environment
Knowledge of all pertinent federal and state regulations, filing and compliance requirements affecting employee benefits programs, including ERISA, ACA, COBRA, FMLA, ADA, Section 125, and DOL requirements
Ability to maintain sensitive information in a strictly confidential manner, exhibiting a high degree of ethics, professionalism and service orientation in all activities and all interactions with internal and external individual
Proactive problem solver and collaborative team player with strong attention to detail, flexibility, and initiative, exercising sound judgment and discretion while effectively operating with minimal supervision
Advanced proficiency in MS Office products (Word/Excel/PowerPoint/Outlook), and Internet and website navigation
analytical and technical support in the delivery of benefit administration
Outstanding verbal and written communication skills required with the ability to successfully interact at all levels of the organization while functioning as a team player
Willingness to take direction and critical feedback, and adapt to improve skills and effectiveness with a positive attitude
Must be able to manage multiple priorities and meet deadlines while maintaining attention to detail and handling stressful situations calmly and professionally in a fast-paced environment

Job Responsibility

Assist with benefits administration of group benefits programs (group health, dental, vision, short-term and long-term disability, life insurance and flexible spending plans) on a daily basis, including monitoring and researching weekly benefit deduction changes and updates
Serve as a subject matter expert and primary point of contact for employee benefit inquiries, providing high-quality service and support to colleagues and HR teams by resolving complex or escalated matters and assisting employees through the benefits hotline during open enrollment and other peak periods
Perform quality checks and audits to ensure accurate benefits data and compliance adherence, support compliance testing and annual audits, and investigate and resolve significant, complex, or unusual issues raised by management or colleagues
Serve as a liaison between colleagues and carriers, handing or facilitating requests for contribution adjustments, refunds, or other administrative changes
Act as liaison for all insurance carriers and third-party administrators for employee eligibility, claim and plan coverage inquiries, providing accurate and timely responses. Coordinates directly with third party administrators to research and resolve issues
Lead the implementation, testing, and maintenance of new and existing carriers EDI files with internal and external teams
Support both automated and manual benefits processes while documenting and maintaining detailed administrative procedures for all assigned benefit responsibilities, including upkeep of the benefits website and share drive to ensure accurate and accessible information
Assist with annual open enrollment activities, including the timeliness of elections to carriers, as well as the annual ACA reporting process by gathering data from third-party administrators, audits, research, and answering employees’ questions
Coordinate daily benefits processing. Handle enrollments, COBRA, terminations, qualifying life event changes, beneficiaries, disability, accident and death claims, and National Support Orders, Employee and Wage verifications, maintain group benefits database and update employee records
Assist with special projects assigned by management team

What we offer

Medical, dental, vision, retirement plan, basic life, AD&D, and disability insurance
Eight paid holidays annually, five sick days, and four personal day
Vacation time offered at an accrual rate of 3.08 hours biweekly. Unused vacation is only paid out where required by law.

Fulltime

Payroll & Benefits Specialist

The Payroll and Benefits Specialist will be responsible for administering payrol...

Location

United States , Minneapolis

Salary:

Not provided

AXEREAL SCA

Expiration Date

Until further notice

Requirements

Minimum 5 years’ experience in payroll, compensation and benefits - experience required in both the US and Canadian context
Bachelor or associates degree in HR or business administration
Strong knowledge of ADP, UKG, or similar payroll systems and excellent logic and analytical skills
Maintains a high degree of confidentiality and integrity
Excellent written and verbal communication skills. Speaks and writes fluently in English.
Strong Excel skills: Pivot Table, V-Lookups, filters, etc
Strong organization aptitude and attention to detail
Solid understanding of payroll and payroll tax laws in both a Canadian and US context
Demonstrated reliability with excellent time-management skills and works well under pressure of deadlines
Knowledge of all pertinent federal and state regulations, filing and compliance requirements both adopted and pending affecting employee benefit programs, including COBRA, Workers Compensation, Medicare, and Social Security requirements.

Job Responsibility

Process bi-weekly payroll for US and Canadian employees, ensuring accuracy and timeliness
Maintain payroll records and ensure compliance with federal, state/provincial, and local regulations
Collaborate with Finance to reconcile payroll accounts and resolve discrepancies
Manage year-end tax reporting (W-2s, T4s, etc.)
Manage benefit programs such as 401k, medical, dental, vision, life, voluntary life, and flexible spending plans
Serve as the primary point of contact for employee benefits inquiries
Coordinate open enrollment processes and communicate benefit changes
Liaise with benefits providers to resolve issues and ensure smooth service delivery
Stay current on labor laws and payroll regulations in both countries
Prepare and submit required government filings and reports

What we offer

We offer an attractive salary and benefits package and as part of a global organization can offer career opportunities internationally. As Masters of Malt we want to be a great employer, focusing on flexibility, inclusion, collaboration and health and wellbeing.

Fulltime

HR Specialist

We are searching for a proficient HR Specialist to join our team in Omaha, Nebra...

Location

United States , Omaha

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 2 years of experience in a HR Specialist role or similar
Proficiency in Benefit Functions, ensuring effective administration and distribution
Demonstrated knowledge and understanding of Compliance within the HR field
Proven ability to handle Employee Relations, fostering positive rapport and resolving conflicts
Experience with Family and Medical Leave Act (FMLA) procedures and regulations
Competence in using ADP for payroll management
Familiarity with Full Cycle Payroll processes, including preparation, input, verification, and reporting
Skilled in HR Payroll System operation and management
Ability to efficiently Process Payroll, ensuring accurate and timely payments
Experience in processing Bi-weekly Payroll, managing all related tasks and duties

Job Responsibility

Management and oversight of organization's benefits programs including health, dental, vision, life insurance, and retirement plans
Accurate and efficient processing and reconciliation of payroll
Timely remittance of payroll taxes and government reporting
Preparation of monthly, quarterly, and year-end payroll statements
Administration of benefits enrollments, terminations, and claims
Research and recommendation of benefits offerings, and negotiation with benefits plan vendors
Communication of changes in benefit programs to employees, including open enrollment schedules
Ensuring compliance with relevant federal and state regulations, filing, and compliance requirements
Maintenance of accurate customer credit records
Resolution of customer inquiries and monitoring of customer accounts

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...

Location

United States , Princeton

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in a similar role
Proficient in benefit functions
Demonstrated expertise in billing functions
Experience in claim administration
Familiarity with collection processes
Ability to handle and resolve medical denials
Comprehensive knowledge of Medicare

Job Responsibility

Analyze and categorize outstanding claims based on payer, denial reason, and claim value
Investigate and take corrective action on unpaid, denied, or underpaid claims
Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
Submit corrected claims and formal appeals as required
Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
Maintain comprehensive records of all payer interactions
Identify the root causes of denials and implement best practices to prevent future issues
Suggest changes to workflow to enhance claim submission accuracy and speed
Conduct training for in-house billing teams on claim recovery strategies

What we offer

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan

Fulltime

People Operations Specialist

You’ll be the backbone of the People Team. You’ll own the operations of hiring, ...

Location

Portugal , Lisbon

Salary:

Not provided

Powerdot

Expiration Date

Until further notice

Requirements

Minimum 3-5 years of HR operations / People operations experience, preferably in a multi-country environment
Solid expertise in compensation & benefits, payroll administration, and salary-structure management
Experience with HRIS/data platforms, strong analytical skills and proficiency in Excel/Google Sheets
Knowledge of labour laws, employment regulations and compliance (preferably across Europe)
Excellent organisational skills, able to manage multiple priorities and stakeholders
Strong problem-solving mindset: you see “how processes could be better” and you act
Fluent in English

Job Responsibility

Manage employment contracts, renewals and for new hires ensure documentation is complete and accurate
Coordinate with hiring managers and Recruiting for start dates and enrolments
Maintain HRIS data for joiners and ensure new-hire workflows and systems are correctly set up
Drive improvements/automation in onboarding and contract administration
Act as point‐of‐contact for the payroll team
ensure timely, accurate payroll support
Administer and track monthly bonuses, commissions and incentive programmes
Maintain salary ranges, job levels, benefits (healthcare, mobility, leave policies), and support budget tracking
Analyse compensation data and provide reports to enable decision-making by leadership
Answer employee queries about payroll, benefits, salary, claims, and partner with Finance as needed

What we offer

Private health insurance coverage
Gym membership to help you stay active
Flexible working hours: you own your time
Annual offsite where we celebrate the year’s achievements and spend quality time together
Regular team-building events with your local teammates
English Training as English is our language used to connect with all markets and teams
Free office snacks and unlimited coffee & Meal allowance for every worked day
Special discounts for charging your electric vehicle

People Operations Specialist

You’ll be the backbone of the People Team. You’ll own the operations of hiring, ...

Location

Lisbon

Salary:

Not provided

Powerdot

Expiration Date

Until further notice

Requirements

Minimum 3-5 years of HR operations / People operations experience, preferably in a multi-country environment
Solid expertise in compensation & benefits, payroll administration, and salary-structure management
Experience with HRIS/data platforms, strong analytical skills and proficiency in Excel/Google Sheets
Knowledge of labour laws, employment regulations and compliance (preferably across Europe)
Excellent organisational skills, able to manage multiple priorities and stakeholders
Strong problem-solving mindset: you see “how processes could be better” and you act
Fluent in English

Job Responsibility

Manage employment contracts, renewals and for new hires ensure documentation is complete and accurate
Coordinate with hiring managers and Recruiting for start dates and enrolments
Maintain HRIS data for joiners and ensure new-hire workflows and systems are correctly set up
Drive improvements/automation in onboarding and contract administration
Act as point‐of‐contact for the payroll team
ensure timely, accurate payroll support
Administer and track monthly bonuses, commissions and incentive programmes
Maintain salary ranges, job levels, benefits (healthcare, mobility, leave policies), and support budget tracking
Analyse compensation data and provide reports to enable decision-making by leadership
Answer employee queries about payroll, benefits, salary, claims, and partner with Finance as needed

What we offer

Private health insurance coverage
Gym membership to help you stay active
Flexible working hours: you own your time
Annual offsite where we celebrate the year’s achievements and spend quality time together (this year we went to Algarve, Portugal!)
Regular team-building events with your local teammates
English Training as English is our language used to connect with all markets and teams
Free office snacks and unlimited coffee & Meal allowance for every worked day
Special discounts for charging your electric vehicle

HR Specialist

We are seeking a detail-oriented HR Specialist in the Food & Food Processing ind...

Location

United States , Middlesex, New Jersey

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Demonstrable experience and proficiency in Compliance
Proficient in Microsoft Excel
In-depth knowledge in HR Compliance
Experience in Benefits Coordination
Excellent skills in Employee Relations
Proficiency in Human Resources (HR) Administration
Experience in Personnel File Maintenance
Knowledgeable in the development, implementation, and management of Policies & Procedures
Demonstrated experience in Recruitment - Sourcing

Job Responsibility

Implementing and managing various human resources plans and procedures for all personnel
Handling weekly payroll operations
Overseeing 401K and health insurance plans for staff
Establishing and enforcing policies, procedures, and guidelines to aid the HR department
Leading recruitment efforts for all levels of personnel, including contract employees
Administering benefits, including managing claims resolution, reporting changes, and communicating benefit details to staff
Facilitating new employee orientations and conducting exit interviews to ensure a positive work experience
Addressing and resolving complex employee relations issues through conducting effective, thorough and objective investigations
Ensuring compliance with federal, state, and local employment laws and regulations, and implementing best practices
Developing and implementing personnel policies and procedures

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Fulltime

New

Claims Benefit Specialist- Life Claims

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Franklin

Salary:

17.00 - 28.46 USD / Hour

CVS Health

Expiration Date

April 30, 2026

Requirements

Must report into Franklin, TN office Tuesday- Thursday
1+ years experience in a high production environment
Experience with Microsoft Office (specifically Excel)
Ability to review and triage documents to the correct location
Ability to multi-task, prioritize, & handle multiple workloads/assignments
Ability to collaborate with team members to resolve any issues

Job Responsibility

Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with funeral homes, beneficiaries and family members, and ensures accurate and timely claims processing
Handles and processes final expense claims submitted by beneficiaries, ensuring accuracy, efficiency, and strict adherence to policies and guidelines
Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope
Documents claim information in the company system, assigning necessary data elements to ensure accurate tracking, reporting, and processing of claims
Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution
Communicates with funeral homes, beneficiaries, family members, or other stakeholders to resolve any discrepancies or issues related to claims
Determines if claims processing activities comply with regulatory requirements, industry standards, and company policies
Develops and implements regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development
Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department
Conducts outbound calls on an as needed bases to respective parties

What we offer

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Fulltime

Claim Benefit Specialist

CVS Health

Location:
United States , Work at Home

Category:
Customer Service

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
March 24, 2026

Expiration:
March 27, 2026

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Claim Benefit Specialist

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Location:United States , Work at Home

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Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:March 24, 2026

Expiration:March 27, 2026

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Expiration:
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