As a Claims Analyst, you are composing, maintaining and clarifying the policies and procedures for the Claims team. Our Claims Analyst is essential to ensuring the Medicare Part D Compliance team is following CMS guidelines. The Claims Analyst is responsible for making sure the policies and procedures are simple and clear for the team to understand, and must be able to answer questions that the team may have. The Claims Analyst is responsible for processing Medicare Part D claims.
As part of the Paper Claims department you will must be able to work well within a team environment as you will be acting as a liaison to internal partners, be able to hit deadlines and be able to set priority expectations for the team to follow.
Additional responsibilities of the Claims Analyst include:
- Being able to resolve situations with policies and procedures
- Utilizing strong communications skills
- Setting your own priorities in a fast paced environment Required Qualifications
2+ years of claims processing experience Preferred Qualifications
- 2+ years of overall experience within Med D Communications
- Strong time management, experience working in a fast paced environment, be an independent thinker, and set own priorities and possess strong communication skills
- Experience working with Microsoft Office Suite products, and claim adjudication platforms
- Ability to work well within a team environment, serves as a liaison to internal partners, and execute against priorities set independently and stated by team in a timely manner
- 3+ years of background with PBM, Claims Administration/Operations, Sales/Consulting and/or Project management experience strongly preferred
- Knowledge or previous experience with Salesforce is preferred
- Knowledge of CMS Chapter 18 GuidanceEducation
High School Diploma or GED required
Bachelor’s Degree preferredBusiness Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, 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
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/