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CVS Health · 1 week ago

Claim Benefit Specialist

Harrisburg, PA

Full-time

Onsite

New Grad, Entry Level

$17/hr - $31.30/hr

CVS Health is the nation’s leading health solutions company, dedicated to transforming health care for millions of Americans. The Claim Benefit Specialist role involves reviewing and adjudicating claims to enhance member satisfaction and retention by providing accurate and timely resolution in processing medical claims.

Health CareMedicalPharmaceuticalRetailSales

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

Qualification

Claim processing experienceAttention to detailMultiple computer applicationsAnalytical skillsKeyboarding skillsWindows environment knowledgeEffective communicationTeamworkAdaptability

Required

Experience in a quality and production environment

Attention to detail

Ability to use multiple computer applications at one time

Claim processing experience

Preferred

Detail oriented individual who enjoys working in a team environment

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

Positive, willing attitude

Prior medical claim processing experience is a plus

Associate's degree preferred

Benefits

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.