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Claim Benefit Specialist at CVS Health - ApplyBlast

Claim Benefit Specialist

CVS Health

2 months ago

3.2 on Glassdoor

Remote

Full Time

Junior

0 applicants

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About this role

The Claim Benefit Specialist processes Medicare medical claims on the HRP-HealthEdge platform, ensuring adherence to CMS guidelines and maintaining quality outcomes. This production-based role supports Medicare Advantage beneficiaries and may work across various Medicare workstreams as needed.

Responsibilities

Review and adjudicate Medicare medical claims
Research and work within multiple computer applications simultaneously
Maintain quality outcomes in a production environment

Skills

About CVS Health

cvshealth.com

Headquarters

Woonsocket, Rhode Island, United States

Company Size

10001+ employees

Founded

1963

View Profile

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.