Senior Claim Benefit Specialist - Stop Loss (Hybrid)

CVS Health

2d • $19 - $42 • Hybrid

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 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 – 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.

Requirements

• Minimum of 1 year of experience in healthcare claims processing
• Minimum of 2 years of experience with the suite of Microsoft applications (particularly Excel)
• High School matriculate or GED equivalent

Nice To Haves

• 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. "green screen", command driven platforms)

Responsibilities

• Managing stop loss claim filings
• Reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier

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: Mid Level
• Education Level: High school or GED