CVS Health

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Claim Reprocessing Associate

at CVS Health

Posted: 1/12/2019
Job Reference #: 923594BR
Categories: Retail
Keywords: retail

Job Description

Job Title :
Claim Reprocessing Associate
Job ID :
923594BR
Location :
RI - Cumberland
Street Address :
200 Highland Corporate Drive
Category :
Finance
Description :
Job Description
As a Claim Reprocessing Associate, you will be responsible for the timely and accurate reprocessing of pharmacy claims that require corporate editing. In this role, you will perform work through our RX Connect system on claims while identifying trends and issues. Additionally, you will facilitate proper handling of claims and recommend solutions to prevent future occurrences.

Your tasks will include outreach to pharmacies to notify them of edits as well as steps taken by corporate to ensure a claim is correctly reprocessed for their store. The Claims Reprocessing Associate is responsible for evaluating the effectiveness of daily claim reprocessing procedures and processes. The Claim Reprocessing Associate will identify opportunities, and recommend/implement process improvements.

Required Qualifications
- Rhode Island Pharmacy Technician License (Tech II)
- 1+ years professional experience in a retail pharmacy or pharmacy call center setting
- 1+ years using Excel in a professional or academic setting

Preferred Qualifications
- CPhT Certification by PTCB
- Basic working knowledge of Excel, Access, and Outlook
- Ability to quickly make sound business decisions
- Ability to work individually and/or with a team
- Ability to identify root causes and define problems
- Ability to recommend/implement viable solutions
- Excellent verbal and written communication skills
- Ability to interact professionally with business partners (i.e. colleagues, managers, directors as well as external entities)
- Ability to complete routinely assigned work based on productivity standards (SLA) with minimal supervision

Education
-Verifiable High School Diploma or GED required.

- Bachelor Degree is preferred (Accounting, Finance, or Business).

Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking Advice and Counsel

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!