Job details
Job type full-time
Full job description
This is a full time, permanent work at home opportunity.
We are looking for highly motivated candidates who are self-driven, collaborative, possess strong claim processing skills, and some experience with claim rework.
Candidates must be able to analyze project and/or individual rework claims for root cause errors, work across teams to correct those errors, and reprocess the claims.
In addition, candidates must be detail-oriented, quality minded, able to recognize trends, be a team player, and meet expected results.
Required qualifications
Responsibilities include:
Identifying the root cause of improperly handled claims and keeps asking `why` to get to the root cause of errors
Communicate as needed to correct issues causing claims to be handled incorrectly
Professional written and verbal communication
Accurately reprocess claims not handled or adjudicated correctly
Provide feedback as needed within and outside team
Balance work volumes to meet expected turnaround times
Work collaboratively for individual and team results
Complete required trainings timely
Meet minimum expected results for the position; e.gProductivity standard, quality metric, etc.
Own personal development and career path.
Covid requirements
Covid-19 vaccination requirement
Cvs health requires its colleagues in certain positions to be fully vaccinated against covid-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one covid-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employmentFor the two covid-19 shot regimen, you will be required to provide proof of your second covid-19 shot within the first 60 days of your employmentFailure to provide timely proof of your covid-19 vaccination status will result in the termination of your employment with cvs health.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with cvs healthAs a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinatedIf your request for an accommodation is not approved, then your employment may be terminated.
Preferred qualifications
1.5+ years claim processing experience preferred but not mandatory.
Experience in a production environment preferred but not mandatory.
Possess strong teamwork and organizational skills.
Have a working knowledge of epdb (provider) preferred but not required.
Demonstrated ability to handle multiple assignments competently, accurately and efficiently.
Education
High school diploma, g.e.dOr equivalent experience
Business overview
At aetna, a cvs health company, we are joined in a common purpose: helping people on their path to better healthWe are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focusedWorking together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplaceCvs health is an equal opportunity and affirmative action employerWe do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran statusWe 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.
