Claim Benefit Specialist

Job not on LinkedIn

🔥 15 hours ago

🏈 Alabama, Alaska, +43 more states – Remote

🏈 Alabama – Remote 🐻 Alaska – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $17 - $31 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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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 rework sensitive, complex medical and hospital claims for the rework project department. • Work closely with Commercial Services Operations team members to perform root cause analysis and precisely resolve affected claims. • Ensure rework project claims are resolved accurately and handled by the rework project due date. • Serve as a medical/hospital claim processor for rework projects, compliance, and complex issues. • Process claims for specific providers/networks or large-scale rework projects resulting from plan sponsor issues, release fallout, and legal, regulatory, or compliance concerns. • Interface with appropriate areas to resolve claims.

🎯 Requirements

• Minimum 1 year of experience in medical claims processing, healthcare billing, revenue cycle operations, or a related healthcare administrative role. • Strong analytical and problem-solving skills with the ability to research and resolve complex claim issues. • Proven ability to manage multiple priorities while meeting quality and turnaround time expectations. • Strong attention to detail and commitment to accuracy. • Proficiency in Microsoft Excel, including sorting, filtering, and basic data analysis. • Demonstrated ability to work effectively in a fast-paced environment while adapting to changing business needs. • High School diploma or equivalent • Experience working in healthcare, insurance, claims processing, medical billing, or customer service. • Knowledge of medical terminology, insurance benefits, or healthcare operations. • Experience using computer systems to research and resolve customer or claim-related issues. • Ability to work independently and collaboratively in a team environment. • Strong organizational and time management skills. • Demonstrated adaptability and willingness to learn new processes and systems.

🏖️ 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