Claim Benefit Specialist

CVS Health•East Lansing, MI

2d•Hybrid

About The Position

Reviews and adjudicates routine Flexible Spending claims in accordance with claim processing guidelines and IRS guidelines. The role includes direct interaction with members to assist with inquiries. The specialist works at a computer for approximately eight hours per day, processing flexible spending claims through electronic images and determining whether submissions are eligible for reimbursement under IRS guidelines. The position requires professional phone and email interactions with members and providers, prompt action when problems arise, maintaining quality and productivity standards, and assisting the Customer Service team. Candidates must reside in close proximity to Lansing, Michigan, and work in the office three days each week, Tuesday through Thursday. Work hours are either 8:00 a.m. to 4:30 p.m. or 8:30 a.m. to 5:00 p.m. Eastern Time. The position is full-time, with 40 anticipated weekly hours. The hourly pay range is $17.00 to $31.30. The position is eligible for a CVS Health bonus, commission, or short-term incentive program, in addition to the base pay range. A comprehensive benefits package is available, subject to eligibility.

Requirements

At least 1 year of data entry or claims processing experience.
At least 1 year of Microsoft Office Suite experience.
Experience working with multiple screens and applications.
Effective organizational skills and ability to manage multiple tasks.
Ability to work effectively in a team environment.
Effective verbal and written communication skills.
Must reside in close proximity to Lansing, Michigan, and be willing to work in the office Tuesday, Wednesday, and Thursday.

Nice To Haves

At least 1 year of Flexible Spending experience.

Responsibilities

Review and adjudicate routine Flexible Spending claims according to claim processing and IRS guidelines.
Process flexible spending claims using electronic images and determine eligibility for reimbursement under IRS guidelines.
Respond professionally to member and provider inquiries by phone and email.
Take prompt action when confronted with a problem or made aware of a situation.
Maintain quality and productivity standards.
Assist the Customer Service team.