Claim Field Analyst, CVS Health

CVS Health

Location:
United States, Tallahassee, Florida

Category:
Customer Service

Contract Type:
Employment contract

Salary:

46988.00 - 91800.00 USD / Year

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Job Description:

The Claim Field Analyst acts as the primary resource for groups and providers, within a specific geographic location, to establish, oversee, and maintain a proactive claim education program focused on assisting providers with claim denials, claim education, and claim resolution.

Job Responsibility:

Act as primary resource for groups and providers to establish, oversee, and maintain proactive claim education program
Analyze claim denials to track and trend potential opportunities
Assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues and billing practices
Collaborate with internal and/or external departments to identify claim training and education opportunities
Develop, implement, support, and promote provider training strategies
Work with grievance and appeal and claims operations department to trend provider claim issues
Meet regularly with assigned providers to conduct trainings and education
Respond to assigned provider claim questions or inquiries

Requirements:

3+ years of experience in medical billing and coding, specifically related to claims processing and root cause analysis
3+ years of experience with provider engagement/relations
Working proficiency of Microsoft Office products (Word, Excel, PowerPoint, Outlook)
Advanced experience in Microsoft Excel for data mining
Must reside in Central Florida - Tampa (Region D - Hardee, Highlands, Hillsborough, Manatee, Polk) and/or Orlando (Region E - Brevard, Orange, Osceola, Seminole)
Ability to travel 70% of time within Central Florida
Ability to work Monday-Friday from 8am-5pm EST, with the flexibility to work beyond core hours as needed

Nice to have:

Excellent verbal and written communication skills
Regular and reliable attendance
Associate's or Bachelor's degree
Certified Professional Coder (CPC) certification

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost 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:
September 06, 2025

Expiration:
September 18, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Claim Field Analyst