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Processor, Paper Claims
CVS Health Corporation
Scottsdale, AZ, United States
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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 paper claims from electronic image in a production environment. Government Paper Claims processes an average of 65,000 claims monthly, and provides service to multiple employer and health plans.
Primary Responsibilities of the Claims Processor include:
-Processing and adjudicating claims from various Government Agencies for Medicare Part D members.
-Processing and adjudicating claims from various commercial employer and health plans
-Maintaining integrity of claims received in accordance with Federal and State laws.
-Researching and accurately resolving claims issues as well as adjudicating errors.
-Working within turnaround times to meet Federal CIA requirements.
-Identifying and reporting trends, errors and providing resolution.
-Meeting productivity and accuracy standards
On-site side by side training will be provided to cover compliance and regulatory requirements, system navigation and claims processing. There will also be opportunity for advancement during our yearly review process.
Required Qualifications
6+ months of relevant experience preferably with claims (medical or dental claims experience will be considered)
1+ year of experience Microsoft Word, Excel and Outlook software
Preferred Qualifications
-Previous PBM Experience
-Access database knowledge
-Medicaid knowledge
-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
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
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CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.