Claim Benefit Specialist

Job not on LinkedIn

🔥 14 hours ago

🦌 Connecticut, Florida, +15 more states – Remote

🦌 Connecticut – Remote 🐊 Florida – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🎸 Tennessee – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote

💵 $17 - $34 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Review and adjudicate claims according to claim processing guidelines • Determine and understand coverage under members' health plans • Use multiple systems and screens to obtain and record claim information • Review claims to determine the nature of members' illnesses or injuries • Identify claim cost management opportunities and refer claims for follow-up • Make claim payment decisions • Process claims accurately and within quality and production standards • Support team members in achieving team, office, regional, and national goals • Provide prompt, efficient, and high-quality claim service to enhance customer satisfaction and retention

🎯 Requirements

• Applicants must reside in the Eastern Time Zone (EST) • Attendance during the 21 week training period is required • Experience in a quality and production environment • Attention to detail • Ability to use multiple computer applications at one time • High School Diploma or equivalent GED • Comfortable with quality goals, production goals, and service expectations • Ability to work overtime after training based on business needs • Prior medical claim processing experience is a plus • Exceptional analytical skills • Accurate and fast keyboarding skills • Advanced computer navigation and knowledge and experience in a Windows environment • Effective verbal and written communication skills • Ability to adapt quickly and willingly to change

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility