Negotiator Analyst (Level I)

CVS Health

6d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator, working with training staff, and team members as more complex cases and strategies are developed.

Requirements

• 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of benchmarking costs for medical services, supplies, and drugs.
• Previous medical provider/business office phone call handling history.
• Strengths in mathematical, written, and verbal skills.

Nice To Haves

• Coding experience, CMS, and/or CPC Certification.
• Proficient in Usual and Customary (calculations) and cost-benchmarking for drugs, supplies, and services.

Responsibilities

• Learn to navigate the systems, and create networking, for this role
• Develop filing, naming conventions, and documentation processes
• Conduct checklist workups and manage outbound communications via phone, fax, and email to facilitate negotiations.
• Work up and organize daily cases
• Make outbound calls, develop provider contacts, and understand production metrics

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree