At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

EDUCATION

• High school diploma or equivalent required.

WHAT YOU WILL DO

• Executes both routine and non-routine business support tasks for the Medical Claims area under limited supervision, referring deviations from standard practices to managers.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Reviews provider billing practices to identify trends and cost savings opportunities.
• Conducts training programs related to claim billing appropriateness and health plan guidelines for claim processors.
• Tests automated code review programs.
• Takes direction to execute techniques, processes, and responsibilities.

FOR THIS ROLE YOU WILL NEED MINIMUM REQUIREMENTS

• Working knowledge of problem solving and decision making skills
• 5+ years work experience
• QXNT experience
• Medicaid experience