Claims Processing - Representative I

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.Position SummaryOur Claims team 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 images in a production environment.Primary Responsibilities of the Claims Processor include:Outbound calls to Members and/or Providers for verification of informationProcessing and adjudicating paper claims.Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.Accurately resolving pending claims using state and federal regulations and specific health plan criteria.Working within turnaround times to meet client performance guarantees for claims processing.Meeting productivity and accuracy standards.Required Qualifications1 year of work experience with a progressive trend in responsibility and accountability, preferably in a Healthcare settingExcellent verbal and written communication skillsIn-depth experience working with Microsoft Office Suite productsThis position is fully remote, but must be able to work the Arizona Time Zone hours.Preferred QualificationsPrevious PBM ExperienceStrong typing skills with speed and accuracyTeam-oriented while also able to pursue personal and departmental production goals dailyAbility to stay organized in a multi-demand and multi-priority environmentAbility to work overtime as necessaryStrong time management skills with ability to meet production goalsEducationHigh School Diploma or equivalent GEDAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $28.46This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visit anticipate the application window for this opening will close on: 07/21/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job Apply tot his job