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:The Sr. Third Party Audit Claim Reprocessing Coordinator will be responsible for the timely, accurate, and compliant management of third-party claim reprocessing audits. This role will facilitate the claim review audit process coordinating between payers and the field to resolve and complete audit documentation requests and inquiries. Their daily tasks will include proactively reviewing and, if
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possible, correcting claims, responding to claim review audits, and evaluating audit discrepancies to mitigate the bad debt associated and influence key stakeholders to implement proactive solutioning efforts.Required Qualifications:
2+ years professional experience, preferably in a retail pharmacy or pharmacy call center setting
Active RI Pharmacy Technician II License
Active PTCB certification (CPhT)
Ability to complete work based on productivity standards (SLA) with minimal supervision
Ability to work individually or with a team to identify and define problems, evaluate alternatives, and implement practical, cost-effective solutionsPreferred Qualifications:
1+ year experience with RxConnect System
2+ years using Excel and Outlook in a professional or academic setting
Ability to interact professionally with business partners (internally and externally)
Excellent verbal and written communication skills
Prompt and concise issue follow up
Ability to quickly make sound decisions while multitasking
Flexibility to adapt to a changing environment
Desire to seek continued professional growthEducation:
Verifiable High School diploma or GED is requiredPay Range
The typical pay range for this role is:$18.50 - $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: 03/15/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.