Our Ability Jobs

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Position Summary

Develops and executes comprehensive testing processes for system enhancements and new products and processes encompassing all aspects of customer service including claims, enrollment, provider contracts, and benefits administration.

• Responsible for creating and executing defined unit testing processes to provide quality audits for vendor contracts prior to implementation.

• Assists with testing simple system enhancements.

• Prepares and executes a comprehensive test plan and test scripts to provide quality audits for vendor contracts to ensure quality and accuracy is maintained.

  -Verifies that system functions according to user requirements and conforms to established guidelines.

• Follows standardized best practices for documenting and executing simple to moderately complex test

  plans.

• Validates test results, documents discrepancies, and follows through with resolutions to ensure all issues are resolved.

• Reports progress of problem resolution to management.

• Communicates test outcomes to end users for sign-off on the results.

• Serves as liaison between the system end users and the IT team.

• Performs other duties as required.

  This position is part of Service Operations

Required Qualifications

• 5+ years related experience in a service center claims processing or managed care operational role.

• 1 year recent and related system processing, payment, and benefits experience, preferably IDX managed care.

• Broad knowledge of medical terminology, claims, customary and reasonable cost containment, coordination of benefits, diagnosis coding, and general customer services sources.

• Excellent verbal and written communication skills. Preferred Qualifications

• QNXT managed care

Education

High School Diploma or GED

Pay Range

The typical pay range for this role is:

$17.00 - $29.88

This 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 04/04/2024

CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.