At CVS Health, weu2019re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nationu2019s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues u2013 caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Are you looking for an exciting opportunity to join a dynamic team that is an important, strategic part of a Fortune 5 company in one of the fastest growing fields in the healthcare industry? This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker relations, underwriting, eligibility, finance, client management and much more. Develop and hone your skills as a critical thinker, problem solver, and highly effective communicator with a meticulous eye for detail and superior organization u2013 foundational skills that will serve you throughout your entire career. We will provide extensive training and a promising career path for the right candidate willing to learn and grow into a promising and stable line of work. You will act as an important liaison and subject matter expert between our internal and external stakeholders and the stop loss administrators. Managing stop loss claim filings, you will reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier. Required Qualifications Minimum of 1 year of experience in healthcare claims processing Minimum of 2 years of experience with the suite of Microsoft applications (particularly Excel) Preferred Qualifications Ability to work independently across a matrix team in a fast-paced environment Strong interpersonal and communication skills (verbal and written) and pride in your work Experience in stop loss administration Exposure to a mainframe IBM AIX or AS/400 environments (i.e.
Job Title
Senior Claim Benefit Specialist - Stop Loss (Hybrid)