Want to use your claims expertise in a role that also allows you to mentor others? CVS Health is hiring Senior Claim Benefit Specialists to review complex medical claims, ensure compliance, and provide subject matter support to the team.
About CVS Health
CVS Health is the nation’s leading health solutions company with 300,000+ colleagues transforming care across the U.S. We’re committed to making healthcare more accessible, affordable, and connected while fostering a workplace where every colleague feels valued.
Schedule
- Full-time, 40 hours per week
- Remote work available in 50 U.S. locations
- Must be able to work efficiently in a production-driven environment
What You’ll Do
- Review and adjudicate complex or specialized medical claims
- Apply medical necessity guidelines and verify eligibility
- Handle pre-authorization, reconsiderations, and appeals
- Identify and report overpayments, underpayments, and irregularities
- Train and mentor junior staff while distributing assignments
- Respond to phone and written inquiries with professionalism
What You Need
- 18+ months of medical claim processing experience
- Strong organizational skills with the ability to manage multiple assignments
- High school diploma required; Associate degree or equivalent work experience preferred
Preferred Skills
- Self-funding experience
- Knowledge of DG system
- Experience mentoring or supporting peers
Benefits
- Pay range: $18.50 – $42.35 per hour, plus CVS bonus/incentive eligibility
- Comprehensive medical, dental, and vision coverage
- 401(k) with company match and employee stock purchase plan
- Paid time off, flexible schedules, family leave
- Tuition assistance, wellness programs, and confidential counseling
Application window closes October 31, 2025—apply early to secure your spot.
Grow your career while helping ensure patients receive the benefits they deserve.
Happy Hunting,
~Two Chicks…