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CVS Health Claim Benefit Specialist - Work from Home- $1000 Sign On Bonus in Pennsylvania

Job Description

This is a work at home opportunity for candidates located in the EST time zone which includes a $1000 sign on bonus as well as an additional $2000 90 days post training!Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have the opportunity to enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims. You will be a key link in providing our customers with prompt, efficient, high quality claim service.

Required Qualifications

• 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 goalsWe are looking for a detail oriented individual who enjoys working in a team environment and can create value for our customers by exceeding high quality metrics. The ideal candidate will have exceptional analytical skills, accurate and fast keyboarding skills, advanced computer navigation and knowledge and experience in a Windows environment, effective verbal and written communication skills, the ability to adapt quickly and willingly to change, and a positive, willing attitude. Prior medical claim processing experience is a plus. Successful candidates should be comfortable with quality goals, production goals, and service expectations and will be monitored for accuracy, efficiency, and customer satisfaction. Comprehensive training will be provided to assist in the achievement of these objectives. Attendance during the 20 week training period is required. After completion of the training period, overtime may be required based on business needs.

Preferred Qualifications

-Experience in a quality and production environment. -Attention to detail. -Ability to use multiple computer applications at one time. -Claim processing experience.


Associates degree preferred but high school diploma or GED equivalent required

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.