Senior Claim Benefit Specialist

CVS Health

2.7

(75)

Columbus, OH

Why you should apply for a job to CVS Health:

  • 62% say women are treated fairly and equally to men
  • 52% say the CEO supports gender diversity
  • Ratings are based on anonymous reviews by Fairygodboss members.

    #R0252574

    Position summary

    that exceed specialist adjudication authority or processing expertise.

    • Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.
    • Insures all compliance requirements are satisfied and all payments are made against company practices and procedures.
    • Identifies and reports possible claim overpayments, underpayments and any other irregularities.
    • Performs claim rework calculations.
    • Makes outbound calls to obtain required information for claim or reconsideration.

    Required Qualifications
    Required 2+ years of Medical claims processing experience

    Familiar with ICD and CPT coding

    Ability to multitask while working independently
    Preferred Qualifications

    Required 2+ years of Medical claims processing experience

    Familiar with ICD and CPT coding

    Ability to multitask while working independently

    Education
    Request a minimum of an Associate's degree which will be waived in lieu of medical claims processing experience.

    Pay Range

    The typical pay range for this role is:

    $18.50 - $35.29

    This 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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

    In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

    For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

    We anticipate the application window for this opening will close on: 06/30/2024

    Why you should apply for a job to CVS Health:

  • 62% say women are treated fairly and equally to men
  • 52% say the CEO supports gender diversity
  • Ratings are based on anonymous reviews by Fairygodboss members.