Sr Claim Benefit Specialist

At CVS Health, we are looking for an experienced Sr Claim Benefit Specialist to join our team and provide exceptional customer service for our patients. The ideal candidate for this role should be passionate about helping others and have a strong understanding of the healthcare reimbursement and benefits process.We are looking for a motivated individual with excellent communication and problem-solving skills who can easily collaborate with other team members, patients, and providers. The successful candidate must have a minimum of 3 years of experience in claims processing with a healthcare organization.In this role, you will be responsible for reviewing, processing, and resolving claims to ensure that our patients receive the best experience possible. You will be required to provide detailed analysis of claims and reimbursement issues, as well as providing timely and accurate responses to both patients and providers. We are looking for someone who can also develop and maintain strong relationships with payers and providers to ensure that our patients’ benefits are maximized.If you have a strong understanding of healthcare reimbursement and benefits and are committed to providing outstanding customer service, we want to hear from you!

Responsibilities:

1. Review, process, and resolve claims to ensure the best experience for patients.
2. Provide detailed analysis of claims and reimbursement issues.
3. Provide timely and accurate responses to both patients and providers.
4. Develop and maintain strong relationships with payers and providers to ensure benefits are maximized.
5. Work with other team members to ensure excellent customer service is provided.
6. Remain up to date on healthcare reimbursement and benefits processes.
7. Monitor claim trends and provide recommendations to improve processes.
8. Troubleshoot and resolve complex claims issues.
9. Ensure compliance with applicable laws and regulations.
10. Prepare reports and documentation of claim activities.

According to JobzMall, the average salary range for a Sr Claim Benefit Specialist is between $48,000 and $87,000 a year. The salary range depends on the company and location, the experience of the specialist, and the specific duties they are expected to carry out. Typically, Sr Claim Benefit Specialists should have at least five years of experience in their respective field in order to earn the higher end of the salary range.

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.