Senior Claim Benefit Specialist

Clinical Careers Page(1 month ago)

MinnesotaOnsiteFull TimeSenior$37,000 - $84,700Claims

About this role

A Claims Specialist at CVS Health who adjudicates complex and sensitive medical claims in accordance with plan and medical necessity guidelines. The role acts as a subject matter expert supporting colleagues and handling member inquiries related to pre-authorizations, reconsiderations, and appeals.

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Required Skills

Claims Adjudication
Medical Necessity
Eligibility Verification
Cost Containment
Customer Service
Claim Rework
Training
Mentoring
Compliance
Phone Communication

Qualifications

New York Independent Adjuster License
High School Diploma
Associates Degree (Preferred)

About Clinical Careers Page

cvshealth.com

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.

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