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CVS Health Benefits Setup Representative Mid Level in Irving, Texas

Job Description

As a Benefits Setup Representative, you will be part of an extremely talented team within our Health Plan Benefits Testing department at CVS Health. In this role, you will be responsible for running queries, claims, and analyzing testing defects. This Representative will need to identify the best approaches and strategies for ensuring the accuracy of benefit and clinical testing across multiple lines of business.

In order to be successful in this role, you must successfully engage internal business partners and leaders, as needed, to resolve issues, drive results, and meet project target dates as required by management.

We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.

This is a full time position. This position is open Monday thru Friday from 2 pm – 10 pm and you must be willing to work 40 hours within this schedule. You should be available for on-call weekend support.

Required Qualifications

  • 2+ years of professional work experience in Claims, Insurance, Testing or a high-production environment

-2+ years of experience with medical insurance, benefits verification, medical billing

-2+ years of experience with Salesforce

Preferred Qualifications

Experience with RxClaim

Experience working in Pharmacy Benefit Management


High school diploma or equivalent required

Business Overview

At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We 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.