Senior Claim Benefit Specialist, CVS Health

Senior Claim Benefit Specialist

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

18.50 - 35.29 USD / Hour

Save Job

Job offer has expired

Job Description:

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. 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, researches and adjudicates complex, sensitive, and/or specialized encounters in accordance with State driven encounter processing guidelines
Works to research and resolve encounter errors
Ensures all compliance requirements are met
Identifies and reports possible claim overpayments, underpayments, scanning issues and any other irregularities

Requirements:

2 years Medical Claims processing experience adjudicating claims (Commercial, Medicaid, Medicare, etc.)
Experience in a production environment
Analytical skills, with the ability to research particularly in areas involving rejected claims
Demonstrated ability to handle multiple assignments competently, accurately, and efficiently
Demonstrated proficiency with personal computer, keyboard navigation skills, and MS Office Suite applications

Nice to have:

QNXT claims processing experience
Encounters experience
Edifecs knowledge

What we offer:

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues 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:
July 11, 2025

Expiration:
July 11, 2025

Employment Type:

Fulltime

Work Type:

Remote work

View All Jobs In This Company

Job Link Share:

Welcome to CrawlJobs.com –
Your Global Job Discovery Platform

At CrawlJobs.com, we simplify finding your next career opportunity by bringing job listings directly to you from all corners of the web. Using cutting-edge AI and web-crawling technologies, we gather and curate job offers from various sources across the globe, ensuring you have access to the most up-to-date job listings in one place.