Operations Accounting-OPS - Coordinator II

, send claims to rework and verify accuracy when needed. The position requires strong verbal and written communication skills and a comprehensive understanding of ACAS claims overpayment scenarios. These skills will be utilized to meet plan sponsor Performance Guarantees.Responsibilities include:

• Review concepts and instructions provided by various constituents targeting overpaid claims
• Follow validation instructions provided by our constituents to properly review ACAS claims for overpayment
• Utilize GPS for claim review
• Utilize SCM where appropriate for claim review
• Review provider contracts in accordance with project concepts and validation

instructions to identify overpaid claims

• Make collection calls to members and providers, coordinating with collection vendors and other internal collection teams
• Refer claims in the ACAS overpayment system to GPS for rework claims after validating as overpaid when appropriateRequired Qualifications

• 2 years' experience working with GPS, SCM, ECHS, and Total Payment Solution (TPS)
• Knowledge of ACAS claims systems
• Familiarity with e.PoliciesAnticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$18.50 - $38.82This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 08/11/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.