Claim Benefit Specialist

CVS Health

Claim Benefit Specialist reviewing and adjudicating claims in accordance with processing guidelines at CVS Health. Ensuring member satisfaction and retention through accurate and timely claims processing.

Posted 5/20/2026full-timeRemote • Texas • 🇺🇸 United StatesMid-LevelSenior💰 $17 - $28 per hourWebsite

About the role

Key responsibilities & impact

Attendance during the 21 week training period is required.
Determine and understand the coverage provided under a member's health plan
Efficiently use multiple systems and screens to obtain and record claim information
Review claims information to determine the nature of a member's illness or injury
Identify claim cost management opportunities and refer claims for follow up
Make claim payment decisions
Process claims accurately to enhance customer satisfaction and retention
Process claims within quality and production standards
Assist team members in support of achieving team, office, regional, and national goals

Requirements

What you’ll need

Experience in a quality and production environment.
Attention to detail.
Ability to use multiple computer applications at one time.
Claim processing experience.
Ability to multi-task
Ability to work independently or as part of a group
Associate’s Degree

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claim processingquality standardsproduction standards

Soft Skills

attention to detailmulti-taskingindependent workteam collaboration

Certifications

Associate’s Degree