by Chris Durst March 30 2023
CVS has posted a work at home Claim Benefit Specialist opportunity to their careers page.
No college required, no state hiring exclusions mentioned.
The pay range is $17-$27.90/hr.
A computer is provided for these openings.
Applicants must live and be able to work in the US.
Here’s what CVS has to say about the job:
Reviews and adjudicates routine Medicare claims on HRP system in accordance with claim processing guidelines. Claims adjudication results should meet/exceed production and quality standards in line with CMS and Aetna compliance and business requirements.
- Analyzes and approves routine claims that cannot be auto adjudicated.
- Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies all cost containment measures to assist in the claim adjudication process.
- Proofs claim or referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis and pre-coding requirements.
- May facilitate training when considered topic subject matter expert.
- In accordance with prescribed operational guidelines, manages claims on desk, route/queues, and ECHS within specified turn-around-time parameters (Electronic Correspondence Handling System-system used to process correspondence that is scanned in the system by a vendor).
- Utilizes all applicable system functions available ensuring accurate and timely claim processing
Note: Our CBS positions in Medicare are not limited to Front-End Claims. These positions can support various Medicare workstreams as determined by business need. This can be either FE Claims, Specialty work or our Rework team.
Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.90
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
- Experience in a production environment
- Detailed and quality oriented
- Ability to research and work within several computer applications simultaneously
- Microsoft Outlook
Preferred Qualifications
- Claim processing experience
- Computer Navigation Proficiency
- Production & Quality background
- Microsoft Office tools
Education
- High School or GED equivalent
CLICK HERE for full details and to apply. For more gigs like these, check our Newest Jobs & Gigs page. To be the first to hear about gigs like these, like our Facebook page. Good luck in your next steps toward working from home!
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