Claim Benefit Specialist Ops

CVS Health is searching for an experienced, organized, and customer service-oriented Claim Benefits Specialist Ops to join our team! The ideal candidate will have prior experience in a healthcare environment, working with insurance companies and customers. This position requires excellent communication and problem-solving skills, an understanding of customer service, and the ability to work as part of a team. We’re looking for someone who is reliable, highly organized and detail-oriented. If this sounds like you and you think you’d be the perfect fit for this role, we’d love to hear from you!Required Qualifications:• Bachelor’s degree in a related field or equivalent experience• Understanding of customer service principles• Working knowledge of health insurance and benefits• Proven track record of being highly organized and detail-oriented• Excellent communication and problem-solving skills• Ability to work as part of a team• Proficiency in Microsoft Office and other relevant software programs

Responsibilities:

1. Process customer claims for health insurance benefits in a timely and efficient manner.
2. Communicate with customers, insurance companies, and other healthcare providers in a professional and courteous manner.
3. Investigate customer inquiries and issues and provide appropriate solutions.
4. Ensure accuracy and completeness of customer information and claims data.
5. Monitor customer accounts to ensure benefits are being used appropriately.
6. Monitor customer accounts for fraud and abuse.
7. Ensure compliance with all relevant policies, procedures, and regulations.
8. Maintain records of customer transactions and communications.
9. Generate reports and other documentation as requested.
10. Perform other duties as assigned.

According to JobzMall, the average salary range for a Claim Benefit Specialist Ops is $43,000 to $60,000. Salaries at this level may vary depending on experience, qualifications, and location.

CVS Health Corp. engages in the provision of health care services. It operates trough the following segments: Pharmacy Services, Retail or Long Term Care, and Corporate. The Pharmacy Services segment offers pharmacy benefit management solutions. The Retail or Long Term Care segment includes selling of prescription drugs and assortment of general merchandise. The Corporate segment involves in providing management and administrative services.