Negotiator Analyst, Level I

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🔥 0 minutes ago

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $43.9k - $102.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• negotiating out-of-network (OON) medical claims valued at $10,000 and above • learning the negotiation role and understanding (U&C) calculated rates and benchmarking of medical costs • developing role as a negotiator, working with training staff, and team members • conducting checklist workups and managing outbound communications via phone, fax, and email • making outbound calls, developing provider contacts, and understanding production metrics

🎯 Requirements

• 3-5 years of experience in a medical claim background with demonstrated ability • strong understanding of benchmarking costs for medical services, supplies, and drugs • previous medical provider/business office phone call handling history • strengths in mathematical, written, and verbal skills • coding experience, CMS, and/or CPC Certification is preferred • proficient in Usual and Customary (calculations) and cost-benchmarking for drugs, supplies, and services

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility