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CVS Health Processor I Paper Claims in Scottsdale, Arizona

Job Description

-Processing and adjudicating claims members, pharmacy's, and providers.

-Processing and adjudicating claims from various commercial employer and health plans

-Maintaining integrity of claims received in accordance with Federal and State laws.

-Researching and accurately resolving claims issues as well as adjudicating errors.

-Working within turnaround times to meet Federal and or state requirements.

-Identifying and reporting trends, errors and providing resolution.

-Meeting productivity and accuracy standards

On-site side by side training will be provided to cover compliance and regulatory requirements, system navigation and claims processing. There will also be opportunity for advancement during our yearly review process.

Required Qualifications

6+ months of relevant experience preferably with claims (medical or dental claims experience will be considered)

1+ year of experience Microsoft Word, Excel and Outlook software.

Preferred Qualifications

Previous PBM Experience

-Access database knowledge

-Medicaid knowledge

-Strong typing skills with speed and accuracy

-Team-oriented while also able to pursue personal and departmental production goals daily

-Ability to organize in a multi-demand and multi-priority environment

-Ability to work overtime as necessary


Verifiable High School Diploma or GED required.

Business Overview

It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm . We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team at mailto:AdviceCounsel@cvshealth.com . Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com . For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.