Medical Claims Analyst

This is a fully remote position, open to applicants in Texas.

📋 Description

• Perform both routine and non-routine business support activities for the Medical Claims department with minimal supervision.

• Adhere to established protocols, standards, and policies to deliver efficient and timely assistance.

• Analyze provider billing practices to uncover trends and potential cost-saving opportunities.

• Facilitate training sessions focused on appropriate claim billing and health plan guidelines for claim processors.

• Evaluate automated code review systems.

• Carry out techniques, processes, and responsibilities as instructed.

• Review and provide accurate claims information to support the optimization of savings for claims.

• Address customer inquiries regarding benefits.

• Uphold customer service standards.

• Implement policies and procedures for managing medical costs.

• Organize support functions for claim adjudication.

⛳️ Requirements

• Proficient in problem-solving and decision-making skills.

• Over 5 years of relevant work experience.

• High school diploma or equivalent is mandatory.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings plans.

• Wellness initiatives.

• Additional resources to support physical, emotional, and financial wellness.