What are the responsibilities and job description for the Paper Claims Processor position at CVS Health?
CVS Health is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic image in a production environment. Government Paper Claims processes an average of 65,000 claims monthly, and provides service to multiple employer and health plans.
Primary Responsibilities of the Claims Processor include:
-Processing and adjudicating claims from various Government Agencies for Medicare Part D members.
-Processing and adjudicating claims from various commercial employer and health plans
-Maintaining integrity of claims received in accordance with Federal and State laws.
-Researching and accurately resolving claims issues as well as adjudicating errors.
-Working within turnaround times to meet Federal requirements.
-Identifying and reporting trends, errors and providing resolution.
-Meeting productivity and accuracy standards
On-site side by side training will be provided to cover compliance and regulatory requirements, system navigation and claims processing. There will also be opportunity for advancement during our yearly review process.
Required Qualifications
-6+ months of relevant experience preferably with claims (medical or dental claims experience will be considered)
-1+ year of experience Microsoft Word, Excel and Outlook software
Preferred Qualifications
-Previous PBM Experience
-Access database knowledge
-Medicaid knowledge
-Strong typing skills with speed and accuracy
-Team-oriented while also able to pursue personal and departmental production goals daily
-Ability to organize in a multi-demand and multi-priority environment
-Ability to work overtime as necessary
Education
High School Diploma or GED required
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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