Claim Benefit Specialist -PF
CVS Pharmacy - Omaha, NE
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Job DescriptionAs a Claim Benefit Specialist, you will enter a challenging, fast pace but rewarding position while providing amazing member experience for our customers. Ultimately, this will enable the delivery of the PayFlex Mission Statement by driving compassion, confidence, and trust while delivering one superior quality experience at a time.Required QualificationsThis role requires attention to detail to ensure we are processing the claim accurately to ensure a great member experience based on the claim form they've submitted for reimbursement. ï± Effective Communication -It is critical to be able to effectively use resources that are available and communicate clearly with your leads/supervisors on any further assistance needed to accurately process the reimbursement claim form that has been submitted by the member. Ability to maintain a professional attitude and respect for peers in the workplace. (i.e. caring, empathy, positive attitude and tone) to drive effective communication amongst your peers.ï± Detail Oriented - Monitors and checks work or information and plans and organizes time and resources efficiently. Key Words: Quality Assurance, Thoroughness, Efficiency. ï± Decision Making / Problem Solving- making use of available tools and resources to make informed decisions while processing claims.ï± Work Independently- When assigned a task(s) you take ownership and don't require constant assistance or supervision to complete that task(s). Once assigned to a claims work queue be able to complete the task with sufficient details to accomplish accuracy while processing.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualificationsï± Prior claim experience preferred, but not required ï± Computer knowledge and skills, comfortable learning new systemsï± Able to learn, memorize and retain information ï± Basic understanding of medical / reimbursement terminology preferred, but not requiredï± Can adapt to a fast paced environmentï± Ability to work overtime and occasional weekends (Jan - Mar) requiredï± Ability to communicate professionally with leads and management teamï± Strong attention to detail needed to maintain accuracy while processingEducationï± High School Diploma / GEDBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Created: 2024-09-07