Daily Review Consultant

  • Company: CVS Health
  • Location: Scottsdale, Arizona
  • Posted: December 08, 2017
  • Reference ID: 730261BR
Position Summary:
You will play the role of a Consultant within the Network Pharmacy department. As Daily Review Consultant, you will review any pharmacy claims submitted through the CVS Health claims processing systems. You will identify and rectify claim inaccuracies that would result in client over-payment. You will also assist in the support of a team of claim reviewers who call pharmacies and evaluate the integrity of claims submitted by providers. In addition, you will assist in training new Lead Coordinators, and evaluate the claims reviewed by the Daily Review team. The individual that oversees this area will have excellent communication skills and must enjoy coaching and mentoring individuals.

Required Qualifications:
- 2+ years of professional work experience, preferably in a retail pharmacy setting.

Preferred Qualifications:
- Knowledge of PBM claim processing systems
- Software application skills (RxClaim, Recap)
- Proficient in Microsoft Excel and Outlook
- Excellent time management skills including planning and ability to maintain and meet strict performance metrics

Verifiable High School Diploma or GED required. Bachelor's Degree preferred

Business 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/

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