Job Description CVS Health is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic image in a production environment.
Primary Responsibilities of the Claims Processor include: -Outbound calls to Members and/or Providers for verification of information -Processing and adjudicating paper claims. -Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures. -Accurately resolving pending claims using state and federal regulations and specific health plan criteria. -Working within turnaround times to meet client performance guarantees for claims processing. -Meeting productivity and accuracy standards
Required Qualifications - 6+ months of professional work experience
Preferred Qualifications -1+ year of claims experience (medical or dental claims) -1+ year of experience Microsoft Word, Excel and Outlook software - Previous PBM Experience - Strong typing skills with speed and accuracy - Team-oriented while also able to pursue personal and departmental production goals daily - Ability to organize in a multi-demand and multi-priority environment - Ability to work overtime as necessary
Education High School Diploma or GED required
Business Overview It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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