As a Benefits Setup Rep (TBD), you will be part of an extremely talented team within our Client Benefits department at CVS Health. You will be responsible for analyzing client requests and performing the necessary benefits review and setup. You’ll work alongside other Benefits Functional areas- Coders, Testers, and Quality Assurance Representatives, as well as our Benefits Relationship Management to deliver high quality support to our client and their lines of business. You will analyze client benefit requests, determine best operational approach and perform coding, manually and through automated support. You will be responsible for meeting or exceeding turnaround time and quality standards as well as researching client benefit requests/issues and recommending alternative solutions to internal partners in meeting client needs. In addition to coding, this position will also be responsible performing QA functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timelines. This position may support coding and QA activities for Strategic Health Plan clients as well as clients with federal/state programs (such as Medicare D, Medicaid, MAPD, RDS, COB, EGWP, HealthCare Reform, etc.)
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
2+ years of related work experience
Extensive history of testing claims submissions as well as proprietary program knowledge – Well organized with the ability to effectively prioritize work –
Ownership and results driven – Customer focused –
Attention to detail – Able to meet aggressive turnaround
time standards/client performance guarantees coupled
with excellent quality – Proficient use Microsoft Office
applications, e.g. Excel, Word – Ability to effectively work
within a team – Flexible in adapting to change –
Demonstrated ability to analyze data and determine
conclusions – Ability to learn and apply increasingly
complex concepts, policies and procedures – Ability to
effectively plan, prioritize, organize time and workload –
Skilled in identifying and solving issues and recommending
process improvements – Ability to work successfully in a
deadline-oriented environment – Excellent verbal and
written communication skills – Project Management skills
Verifiable High School diploma or GED is required.
Bachelor’s degree or equivalent experience prefered.
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. 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.