Support accurate claim adjudication and help members receive timely, high-quality service.
About CVS Health
CVS Health is the nation’s leading health solutions company, serving millions through retail pharmacies, digital platforms, and clinical care programs. With more than 300,000 employees committed to improving lives, CVS Health delivers care that is more connected, convenient, and compassionate. This role supports the Customer Care organization by reviewing and processing medical claims accurately and efficiently.
Schedule
- Full-time, 40 hours per week
- Remote position available in multiple U.S. locations
- Mandatory attendance during the 21-week training period
- Overtime may be required based on business needs
Responsibilities
- Review and adjudicate medical claims according to processing guidelines
- Determine coverage based on a member’s health plan
- Navigate multiple systems and screens to gather and enter claim information
- Validate details of illness or injury to ensure processing accuracy
- Identify cost-management opportunities and escalate when appropriate
- Make claim payment decisions and process claims within quality and production standards
- Support team goals at the office, regional, and national levels
- Maintain accuracy, speed, and service quality expectations
Requirements
- Experience in a quality-driven, production-based environment
- Strong attention to detail
- Ability to work across multiple computer applications simultaneously
Preferred Qualifications
- Prior medical claim processing experience
- Strong analytical skills and fast, accurate keyboarding
- Advanced computer navigation skills in Windows environments
- Clear written and verbal communication
- Ability to adapt quickly to change and maintain a positive attitude
- Associate degree
Education
- High School Diploma or GED required
Benefits
- Competitive pay: $17.00–$34.15 per hour (based on experience and location)
- Medical, dental, and vision plans
- 401(k) with company match and employee stock purchase plan
- Paid time off, family leave, and flexible scheduling options
- No-cost wellness programs, counseling, and financial coaching
- Tuition assistance and long-term career development
- Supportive workplace culture focused on belonging and wellbeing
CVS Health invests in your physical, emotional, and financial wellness so you can thrive at work and at home.
Happy Hunting,
~Two Chicks…