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Med D Claims Analyst

4 months ago

Phoenix, United States CVS Health Full time

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

**Position Summary**

As a Claims Analyst, you are responsible for analyzing submitted documentation, making outbound calls to obtain required information, and processing Medicare Part D claims per CMS regulations. This position requires a methodical attention to detail, strong analytic thinking, and the ability to multi-task in a production based and time sensitive environment.

Additional characteristics of the Claims Analyst include:

- Being able to resolve situations with written policies and procedures.
- Be able to meet deadlines, expectations, and production, quality, and performance standards.
- Possess exceptional analytical abilities. You must be able to manage a personal claims inventory consisting of varying complexities, urgencies, and deadlines.
- Must be able to work well within a team environment as you will be acting as a liaison to internal partners.
- Must be an independent worker and be able to set your own priorities in a fast-paced environment.

**Required Qualifications**
- 3 plus years of work experience that shows a progressive trend in responsibility and accountability.
- Excellent verbal and written communication skills.
- In-depth experience working with Microsoft Office Suite products.

**Preferred Qualifications**
- 2+ years of claims processing experience.
- 2+ years of overall experience within Medicare Part D or in a PBM setting.
- 2+ years of professional work experience. Professional work experience is described as 'work that requires a certain level of education, skill, or training, with a lesser degree of supervision than average.'
- Knowledge or previous experience with Salesforce is preferred.
- Knowledge of CMS Guidance.
- Bachelor's Degree preferred

**Education**
High School Diploma or equivalent GED required

**Pay Range**

The typical pay range for this role is:
$40,600.00 - $85,100.00

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.