Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary
Develops and executes comprehensive testing processes for system enhancements and new products and processes encompassing all aspects of customer service including claims, enrollment, provider contracts, and benefits administration.
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- Responsible for creating and executing defined unit testing processes to provide quality audits for vendor contracts prior to implementation.
- Assists with testing simple system enhancements.
- Prepares and executes a comprehensive test plan and test scripts to provide quality audits for vendor contracts to ensure quality and accuracy is maintained.
-Verifies that system functions according to user requirements and conforms to established guidelines.
- Follows standardized best practices for documenting and executing simple to moderately complex test
plans.
- Validates test results, documents discrepancies, and follows through with resolutions to ensure all issues are resolved.
- Reports progress of problem resolution to management.
- Communicates test outcomes to end users for sign-off on the results.
- Serves as liaison between the system end users and the IT team.
- Performs other duties as required.
This position is part of Service OperationsRequired Qualifications
- 5+ years related experience in a service center claims processing or managed care operational role.
- 1 year recent and related system processing, payment, and benefits experience, preferably IDX managed care.
- Broad knowledge of medical terminology, claims, customary and reasonable cost containment, coordination of benefits, diagnosis coding, and general customer services sources.
- Excellent verbal and written communication skills.
Preferred Qualifications
- QNXT managed careEducation
High School Diploma or GEDPay Range
The typical pay range for this role is:$17.00 - $34.15This 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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS HealthWe anticipate the application window for this opening will close on: 01/20/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.