• Job Description

  Req#: R0493967

  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

  Completes the preparation and submission of claims for accounts to ensure timely reimbursements. Communicates with nursing facility staff, physician offices, and insurance companies to maintain payment deliverables for online claim submissions.

  Responsibilities

  • Follows established procedures to execute routine business support tasks for the Adjudication OCR function under general supervision.

  • Develops effective relationships with all team members to ensure daily communication to resolve issues and prevent delays in service.

  • Conducts review and research of rejected claims and takes action for resolution.

  • Handles work backlog of denied claims for timely resubmission.

  • Ensures compliance with all government and regulatory requirements.

  • Takes direction to execute techniques, processes, and responsibilities.

  Required Qualifications

  • High school diploma
  • Entry-Level familiarity with Excel/Access
  • Perform multiple tasks effectively
  • Able to work both independently and as part of a team

  
  Preferred Qualifications

  • Pharmacy technician certification highly preferred
  • Experience in pharmacy, managed care, Medicaid and/or Medicare organizations

  
  Education
  High School Diploma or Equivalent

  Anticipated Weekly Hours

  40

  Time Type

  Full time

  Pay Range

  The typical pay range for this role is:

  $17.00 - $28.46

  This 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.
  
  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 Health

  We anticipate the application window for this opening will close on: 03/14/2025

  Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

• About the company

  At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.

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