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. • You will be a key link in providing our customers with prompt, efficient, high quality claim service. • Determine and understand the coverage provided under a member's health plan. • Efficiently use multiple systems and screens to obtain and record claim information. • Review claims information to determine the nature of a member's illness or injury. • Identify claim cost management opportunities and refer claims for follow up. • Make claim payment decisions. • Process claims accurately to enhance customer satisfaction and retention. • Process claims within quality and production standards. • Assist 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. • Attendance during the 21 week training period is required. • Prior medical claim processing experience is a plus. • Exceptional analytical skills. • Accurate and fast keyboarding skills. • Knowledge and experience in Windows environment. • Effective verbal and written communication skills. • Ability to adapt quickly and willingly to change. • Positive, willing attitude. Benefits: • Great benefits for great people • We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. • In addition to our competitive wages, our great benefits include: 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