Senior Claim Benefit Specialist, CVS Health

CVS Health

Location:
United States, Amherst

Category:
Customer Service

Contract Type:
Employment contract

Salary:

18.50 - 38.82 USD / Hour

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Job Description:

This role provides exposure to various aspects of healthcare claims administration, including reinsurance/stop loss, data analytics, provider and broker relations, underwriting, eligibility, finance, and client management. You will develop key skills like critical thinking, problem-solving, and effective communication while acting as a liaison and subject matter expert for stakeholders and managing stop loss claim filings.

Job Responsibility:

Act as an important liaison and subject matter expert between internal and external stakeholders and the stop loss administrators
Manage stop loss claim filings
Reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier

Requirements:

Minimum of 1 year of experience in healthcare claims processing
Minimum of 2 years of experience with the suite of Microsoft applications (particularly Excel)

Nice to have:

Ability to work independently across a matrix team in a fast-paced environment
Strong interpersonal and communication skills (verbal and written) and pride in your work
Experience in stop loss administration
Exposure to a mainframe IBM AIX or AS/400 environments (i.e. "green screen", command driven platforms)

What we offer:

Affordable medical plan options
401(k) plan (including 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:
April 30, 2025

Expiration:
July 31, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Senior Claim Benefit Specialist