Senior Claim Benefit Specialist

We're looking for a high-impact individual to join reputed company as a Senior Claim Benefit Specialist! Whether you're in our Remote hub or working remotely, you'll be a core part of the team. This position requires a strong and diverse skillset in relevant areas to drive success. An attractive remuneration of a competitive salary is on offer for the successful candidate.

 

 

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary Reviews and adjudicates reputed company, sensitive, and/or specialized claims in accordance with plan processing guidelines. - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies reputed company cost containment. measures to assist in the claim adjudication process. - Insures reputed company compliance requirements are satisfied and reputed company payments are made against company practices and procedures. - Identifies and reports possible claim overpayments, underpayments and any other irregularities. - Performs claim rework calculations. - Makes outbound calls to obtain required information for claim or reconsideration. Required Qualifications Required 2+ years of Medical claims processing experience Familiar with ICD and CPT coding Ability to multitask while working independently Preferred Qualifications Required 2+ years of Medical claims processing experience Familiar with ICD and CPT coding Ability to multitask while working independently Education Request a minimum of an Associate's degree which will be waived in lieu of medical claims processing experience. Pay Range The typical pay range for this role is: $18.50 - $35.29 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits This job does not have an application deadline, as reputed company accepts applications on an ongoing basis Apply Job! For more such jobs please click here!

 

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