Position Summary: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 Aetna Commercial paper claims from electronic image in a production environment.
Primary Responsibilities of the Claims Processor include:
-Processing and adjudicating Aetna Commercial 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.
A training course will be provided on site to cover compliance and regulatory requirements, system navigation and comprehensive claims processing. There will also be opportunity for advancement during our yearly review process. Required Qualifications:-1+ year of claims experience (medical or dental claims experience will be considered) -1+ year of experience Microsoft Word, Excel and Outlook software Preferred Qualifications:- 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 requiredBusiness 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 AA EEO CVS Health
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/