Senior Claim Benefit Specialist - Remote
Clinical Careers Page(20 days ago)
About this role
This role involves reviewing and adjudicating complex medical claims, ensuring compliance with guidelines, and supporting customer service operations to improve the member experience. It requires technical expertise in medical claim processing within a healthcare insurance setting.
Required Skills
- claims Processing
- Medical Necessity
- Regulatory Compliance
- Customer Service
- Claims Rework
- Mentoring
- Eligibility Verification
- Cost Containment
- Data Analysis
- Healthcare Software
About Clinical Careers Page
cvshealth.comCVS 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.
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