Claim Benefit Specialist

Description: Reviews and adjudicates claims in accordance with claim processing guidelines.Claim Benefit Specialists have the opportunity to enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims.Determine and understand the coverage provided under a member's health planEfficiently use multiple systems and screens to obtain and record claim informationReview claims information to determine the nature of a member's illness or injuryIdentify claim cost management opportunities and refer claims for follow upMake claim payment decisionsProcess claims accurately to enhance customer satisfaction and retentionProcess claims within quality and production standardsAssist team members in support of achieving team, office, regional, and national goals Requirements: Experience in a quality and production environment.Attention to detail.Ability to use multiple computer applications at one time.Claim processing experience.Associates Degree EducationHigh School diploma or equivalentAttendance during the 21 week training period is required.After completion of the training period, overtime may be required based on business needs. Benefits: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan . No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits Apply tot his job Apply To this Job