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Claim Benefit Specialist - Work From Home

AT CVS Health
CVS Health

Claim Benefit Specialist - Work From Home

Olympia, WA

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
This role is for Meritain Health PBM Operations Team and is responsible for processing PBM vendor invoices and claims. The PBM Processor is assigned a set of groups to maintain their invoices on a weekly, bi-weekly or monthly basis.Job Duties include (but not limited to):

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Imports and monitors PBM claims data and invoice files.
Reconciles and balances claims data and invoices in the claims processing system.
Coordinates client billing and invoice payments.
Communicate invoice processing errors/delays to Client Management.
Communicate missing files for assigned book of business to File Management.
Maintain Invoice Tracker by keeping assigned book of business up to date.
Manage special accommodation products as required. (i.e. International Sourced Drugs, complex PBM vendors, high profile clients).
Reconcile aging reports and stop loss inquiries.
Meet key performance metrics including production, quality, and turnaround time.

The ability to independently handle multiple assignments competently, accurately, and efficiently.Required Qualifications

2 years + experience with data entry or claims processing experience

1-3 years of Customer Service experience

If near an office location; Onsite 3 days will be required

Preferred Qualifications
High Level understanding and use of Microsoft Excel

Strong attention to detail
Work effectively in a team environment
Ability to work overtime if necessaryEducation

High School diploma, G.E.D. or equivalent experience. Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$17.00 - $31.30This 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: 03/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Olympia, WA, USA
Job ID: CVS-R0499687_1020
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program