Medical Claim Analyst

CVS Health • Baton Rouge, LA

439d • $38,480 - $65,978 • Remote

About The Position

The Medical Claim Analyst position at CVS Health involves inspecting and providing accurate claim information to optimize savings for claims. The role requires responding to customer inquiries regarding benefits, maintaining customer service standards, and administering policies for medical cost management. The analyst will coordinate support functions for claim adjudication and execute both routine and non-routine business support tasks under limited supervision.

Requirements

• Working knowledge of problem solving and decision making skills
• 5+ years work experience
• High school diploma or equivalent required.

Responsibilities

• Executes both routine and non-routine business support tasks for the Medical Claims area under limited supervision.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Reviews provider billing practices to identify trends and cost savings opportunities.
• Conducts training programs related to claim billing appropriateness and health plan guidelines for claim processors.
• Tests automated code review programs.
• Takes direction to execute techniques, processes, and responsibilities.

Benefits

• Full range of medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance plan
• Short-term and long-term disability benefits
• Well-being programs
• Education assistance
• Free development courses
• CVS store discount
• Discount programs with participating partners
• Paid Time Off (PTO) or vacation pay
• Paid holidays throughout the calendar year

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Health and Personal Care Retailers
• Education Level: High school or GED