Employer: CVS Health
As a Claims Analyst, you are responsible for analyzing submitted documentation, making outbound calls to obtain required information, and processing Medicare Part D claims per CMS regulations. This position requires a methodical attention to detail, strong analytic thinking, and the ability to multi-task in a production based and time sensitive environment.
Additional characteristics of the Claims Analyst include:
- Being able to resolve situations with written policies and procedures
- Be able to meet deadlines, expectations, and production, quality, and performance standards.
- Possess exceptional analytical abilities. You must be able to manage a personal claims inventory consisting of varying complexities, urgencies, and deadlines.
- Must be able to work well within a team environment as you will be acting as a liaison to internal partners.
- Must be an independent worker and be able to set your own priorities in a fast-paced environment
Required Qualifications
- At least 3 years of work experience that shows a progressive trend in responsibility and accountability
- Excellent verbal and written communication skills
- In-depth experience working with Microsoft Office Suite products
COVID Requirements
CVS Health requires its Colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work. If your request for an accommodation is not approved, then your employment may be terminated.
Preferred Qualifications
- 2+ years of claims processing experience
- 2+ years of overall experience within Medicare Part D or in a PBM setting
- 2+ years of professional work experience. Professional work experience is described as work that requires a certain level of education, skill, or training, with a lesser degree of supervision than average.
- Knowledge or previous experience with Salesforce is preferred
- Knowledge of CMS Guidance
Education
Bachelor s Degree Strongly Preferred