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
Are you looking for an exciting opportunity to join a dynamic team that is a key, strategic part of a Fortune 5 company in one of the fastest growing industry fields? This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss policy, data analytics, provider and broker relations, underwriting, eligibility, finance, client management and much more. Hone your skills as a proven critical thinker and problem solver with a meticulous eye for detail and superior organization - foundational skills that will serve you over your entire career. We will provide extensive training for the right candidate willing to learn and grow into a promising and extremely stable line of work.You will act as an important liaison and subject matter expert throughout our internal and external stakeholder groups and the stop loss carriers that our clients contract with. Helping to managing stop loss claim filings, you will reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier. That responsibility will involve such things as:
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- Serving as an advocate for our clients in helping to recover the maximum eligible reimbursements covered under the stop loss policies
- Utilizing rolling reports and analysis to monitor employer groups/clients assigned to you
- Both creating and updating system-generated and manually created stop loss filing package(s)
- Tracking and posting stop loss reimbursements
- Researching and resolving complex cases that require additional explanation
- Engaging with multiple functional areas as required in order to facilitate the overall resolution of impacted filings for employer groups in your assigned portfolio
- Minimum of 1 year of experience in healthcare claims processing
- Minimum of 3 year of experiences with the suite of Microsoft applications (particularly, Excel)
- Ability to work independently across a matrix team in a fast-paced environment
- Strong interpersonal and communication skills (verbal and written)
- Stop Loss/reinsurance experience
- Exposure to a mainframe IBM AIX or AS/400 environments
Undergraduate Degree or 5 years equivalent work experience Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$17.00 - $38.82This 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: 03/14/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.