Claim Benefit Specialist

CVS Health

Claim Benefit Specialist reviewing and adjudicating complex medical and hospital claims for CVS Health. Collaborating with team members to ensure accurate and timely resolution of claims.

Posted 6/10/2026full-timeHartford • Connecticut, Idaho, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $17 - $31 per hourWebsite

About the role

Key responsibilities & impact

Review and adjudicate claims in accordance with ACAS claim processing guidelines
Work closely with other members of the Commercial Services Operations team providing root cause analysis and precise resolution of affected claims
Ensure the rework project claims are resolved accurately and on time
Serve as a medical/hospital claim processor for rework projects, compliance, and complex issues

Requirements

What you’ll need

Experience in a production environment
Proven ability to provide excellent service by meeting key performance metrics including production, quality, and turnaround time
Possess strong teamwork and organizational skills
Demonstrated ability to handle multiple assignments competently, accurately and efficiently
ACAS claim system experience preferred
Detail oriented, root cause problem solving, organized and able to manage multiple priorities
High School Diploma

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Soft Skills

teamworkorganizational skillsdetail orientedroot cause problem solvingability to handle multiple assignmentsaccuracyefficiency

Certifications

High School Diploma