Claims Processing Representative I

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
Position is remote, but work schedule will be based off AZ time zone.
Our Claims team is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic images in a production environment. 

Primary Responsibilities of the Claims Processor include: 
-Outbound calls to Members and/or Providers for verification of information 
-Processing and adjudicating paper claims. 
-Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures. 
-Accurately resolving pending claims using state and federal regulations and specific health plan criteria. 
-Working within turnaround times to meet client performance guarantees for claims processing. 
-Meeting productivity and accuracy standards

Required Qualifications

-At least 1 year of work experience that shows a progressive trend in responsibility and accountability preferably in a Healthcare setting.

-Excellent verbal and written communication skills

-In-depth experience working with Microsoft Office Suite products

Preferred Qualifications
- Call center type experience
- Previous PBM Experience 
- Strong typing skills with speed and accuracy 
- Team-oriented while also able to pursue personal and departmental production goals daily 
- Ability to stay organized in a multi-demand and multi-priority environment 
- Ability to work overtime as necessary

Education

Verifiable High School Diploma or GED required

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.