At CVS Health, we are looking for an experienced Sr Claim Benefit Specialist to join our team and provide exceptional customer service for our patients. The ideal candidate for this role should be passionate about helping others and have a strong understanding of the healthcare reimbursement and benefits process.We are looking for a motivated individual with excellent communication and problem-solving skills who can easily collaborate with other team members, patients, and providers. The successful candidate must have a minimum of 3 years of experience in claims processing with a healthcare organization.In this role, you will be responsible for reviewing, processing, and resolving claims to ensure that our patients receive the best experience possible. You will be required to provide detailed analysis of claims and reimbursement issues, as well as providing timely and accurate responses to both patients and providers. We are looking for someone who can also develop and maintain strong relationships with payers and providers to ensure that our patients’ benefits are maximized.If you have a strong understanding of healthcare reimbursement and benefits and are committed to providing outstanding customer service, we want to hear from you!
Responsibilities:
Review, process, and resolve claims to ensure the best experience for patients.
Provide detailed analysis of claims and reimbursement issues.
Provide timely and accurate responses to both patients and providers.
Develop and maintain strong relationships with payers and providers to ensure benefits are maximized.
Work with other team members to ensure excellent customer service is provided.
Remain up to date on healthcare reimbursement and benefits processes.
Monitor claim trends and provide recommendations to improve processes.
Troubleshoot and resolve complex claims issues.
Ensure compliance with applicable laws and regulations.
Prepare reports and documentation of claim activities.
CVS Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.