Claims Benefit Specialist- Life Claims

CVS Health•Franklin, TN

1d•$17 - $28•Onsite

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.

Requirements

Must report into Franklin, TN office Tuesday- Thursday
1+ years experience in a high production environment
Experience with Microsoft Office (specifically Excel)
Ability to review and triage documents to the correct location
Ability to multi-task, prioritize, & handle multiple workloads/assignments
Ability to collaborate with team members to resolve any issues

Nice To Haves

1-2 years Experience in a final expense claims processing environment

Responsibilities

Handles and processes final expense claims submitted by beneficiaries, ensuring accuracy, efficiency, and strict adherence to policies and guidelines.
Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope.
Documents claim information in the company system, assigning necessary data elements to ensure accurate tracking, reporting, and processing of claims.
Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution.
Communicates with funeral homes, beneficiaries, family members, or other stakeholders to resolve any discrepancies or issues related to claims.
Determines if claims processing activities comply with regulatory requirements, industry standards, and company policies.
Develops and implements regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development.
Analyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department.
Conducts outbound calls on an as needed bases to respective parties