Claim Benefit Specialist

CVS Health•New York, VT

10d•$17 - $34•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. - Attendance during the 21 week training period is required. After completion of the training period, overtime may be required based on business needs. - Applicants must reside in the Eastern Time Zone (EST) Job Summary Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the opportunity to enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims. You will be a key link in providing our customers with prompt, efficient, high quality claim service. We are looking for a detail oriented individual who enjoys working in a team environment and can create value for our customers by exceeding high quality metrics. Attendance during the 21 week training period is required. After completion of the training period, overtime may be required based on business needs.

Requirements

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
Reside in the Eastern Time Zone (EST)

Nice To Haves

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, and a positive, willing attitude.
Successful candidates should be comfortable with quality goals, production goals, and service expectations and will be monitored for accuracy, efficiency, and customer satisfaction.
Associate’s Degree

Responsibilities

Determine and understand the coverage provided under a member's health plan
Efficiently use multiple systems and screens to obtain and record claim information
Review claims information to determine the nature of a member's illness or injury
Identify claim cost management opportunities and refer claims for follow up
Make claim payment decisions
Process claims accurately to enhance customer satisfaction and retention
Process claims within quality and production standards
Assist team members in support of achieving team, office, regional, and national goals