Job Description
Job Description
CVS Health has an exciting new opportunity within the
Claims team Our Claims team is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic image in a production environment.
Primary Responsibilities of the Claims Processor include:
-Outbound calls to Members and/or Providers for verification of information
-Processing and adjudicating paper claims.
-Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
-Accurately resolving pending claims using state and federal regulations and specific health plan criteria.
-Working within turnaround times to meet client performance guarantees for claims processing.
-Meeting productivity and accuracy standards
We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.
Required Qualifications
- 6+ months of professional work experience
Preferred Qualifications
-1+ year of claims experience (medical or dental claims)
-1+ year of experience Microsoft Word, Excel and Outlook software
- Previous PBM Experience
- Strong typing skills with speed and accuracy
- Team-oriented while also able to pursue personal and departmental production goals daily
- Ability to organize in a multi-demand and multi-priority environment
- Ability to work overtime as necessary
Education
Verifiable High School Diploma or GED required
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
CVS Health has an exciting new opportunity within the
Claims team Our Claims team is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic image in a production environment.
Primary Responsibilities of the Claims Processor include:
-Outbound calls to Members and/or Providers for verification of information
-Processing and adjudicating paper claims.
-Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
-Accurately resolving pending claims using state and federal regulations and specific health plan criteria.
-Working within turnaround times to meet client performance guarantees for claims processing.
-Meeting productivity and accuracy standards
We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.
Required Qualifications
- 6+ months of professional work experience
Preferred Qualifications
-1+ year of claims experience (medical or dental claims)
-1+ year of experience Microsoft Word, Excel and Outlook software
- Previous PBM Experience
- Strong typing skills with speed and accuracy
- Team-oriented while also able to pursue personal and departmental production goals daily
- Ability to organize in a multi-demand and multi-priority environment
- Ability to work overtime as necessary
Education
Verifiable High School Diploma or GED required
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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