Help shape the future of healthcare while working from home with CVS Health.
About CVS Health
CVS Health is the nation’s leading health solutions company, connecting with millions of Americans every day. With over 300,000 colleagues, CVS delivers care that’s compassionate, convenient, and uniquely connected across local communities and digital channels.
Schedule
- Full-time, 40 hours per week
- Remote role (available in 50 U.S. locations)
- Standard weekday schedule with occasional flexibility required
What You’ll Do
- Review and adjudicate complex or specialized claims using plan guidelines.
- Apply medical necessity rules, verify eligibility, and ensure compliance with cost-containment measures.
- Handle inquiries related to pre-approvals, reconsiderations, and appeals.
- Identify and report irregularities such as overpayments or discrepancies.
- Mentor junior claim specialists and manage daily work assignments.
What You Need
- New York Independent Adjuster License.
- High school diploma required (Associate’s degree preferred).
- Experience in a production environment with strong multitasking skills.
- 18+ months of medical claim processing experience preferred.
- Familiarity with self-funding and DG systems is a plus.
Benefits
- Competitive pay: $18.50–$42.35/hr plus bonus eligibility.
- Medical, dental, and vision insurance options.
- 401(k) with company match and employee stock purchase plan.
- Paid time off, flexible work schedules, and family leave.
- Wellness, counseling, tuition assistance, and career growth programs.
This role closes applications on October 1, 2025 – don’t miss out.
Be part of a team that leads with heart and purpose.
Happy Hunting,
~Two Chicks…