April 14, 2024

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[New Job Vacancy] job in CVS Health, (Ohio) – Jobs in Ohio

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Job Opening details:-
Company Name :-
CVS Health
Position Name :-

Company Location :-
Job Category :-

Full Job Description :-
We are looking for a highly motivated candidate who can work across teams to provide subject matter expertise.
The claim lifeline specialist will respond to Lifeline inquires and handle real time member rework. The candidate selected should be able to effectively collaborate with Member Services and serve as a claim expert and will rework claims real time to expand our current service model.
The candidate will be responsible to staff the Claim Lifeline, respond to claim inquiries from the Member Services team and rework claims when appropriate. They will be responsible to provide education when appropriate and watch for trends to help mitigate the risk of ongoing rework. The Claim Lifeline will be open and staffed from 8:00am – 9:00pm ET.
Required Qualifications
The ideal candidate will :
2+years ACAS claim processing experience is required.Knowledge of EPDB, SCM inquiry & Plan Systems is essential.Ability to analyze claims, identify root causes and
solve problems quickly.
Excellent oral and written communications skills.Self driven and ability to manage multiple priorities.Be efficient and flexible to meet organizational goals.
COVID Requirements
COVID-19 Vaccination Requirement
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.
Preferred Qualifications
Functional -Claims -Claims processing -Medical or
Hospital – ACAS /1-3 Years
Functional – Products- Medical – All Aetna Standard
Plans/1-3 Years
Technical – Aetna Applications- Enterprise Provider
Database Systems /1-3 Years/End User
Technical -Aetna Applications-Strategic Contracts
Manager/1-3 Years/End User
Technical – Desktop Tools – Microsoft Foundational Classes /1-3 Years/End User
Creating a Differential Services ExperienceDriving a Culture of ComplianceProviding Solutions to Constituents Needs
High School diploma G.E.D. or equivalent experience.
Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.

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