Description
CVS Health is seeking a highly motivated Medical/Hospital Claim Processor for Rework Projects to join our Commercial Services Operations team. You will review and rework sensitive, complex medical and hospital claims, providing root cause analysis and precise resolution of affected claims. Your goal will be to ensure accurate resolution of rework project claims, interface with relevant areas, and meet deadlines.
Responsibilities
- Review and rework complex medical and hospital claims
- Provide root cause analysis and precise resolution of affected claims
- Interface with relevant areas to resolve claims
- Ensure accurate and timely resolution of rework project claims
Requirements
- Minimum 1 year of experience in medical claims processing, healthcare billing, revenue cycle operations, or a related healthcare administrative role
- Strong analytical and problem-solving skills
- Ability to manage multiple priorities while meeting quality and turnaround time expectations
- Strong attention to detail and commitment to accuracy
- Proficiency in Microsoft Excel, including sorting, filtering, and basic data analysis
- Demonstrated ability to work effectively in a fast-paced environment while adapting to changing business needs
Preferred Qualifications
- Experience working in healthcare, insurance, claims processing, medical billing, or customer service
- Knowledge of medical terminology, insurance benefits, or healthcare operations
- Experience using computer systems to research and resolve customer or claim-related issues
- Ability to work independently and collaboratively in a team environment
- Strong organizational and time management skills
- Demonstrated adaptability and willingness to learn new processes and systems
Benefits
- Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources
For more fresh new jobs, check out yubhub.co.