Encounters- Claim Data Specialist – CVS Health

5% 1-Year Employee Growth Rate | 13% 2-Year Employee Growth Rate | LinkedIn | $0 Venture Funding

What Is Employee Growth Rate & Why Is It Important?

Job Description
This position will collaborate with other MCO’s to resolve duplicate encounter errors, and reprocess claims as needed to resolve encounter errors. Regularly communicate with other departments and demonstrate an ability to communicate clearly and professionally via email. This position will also research Medicaid claim issues beyond written desktop procedures using state documentation and other relevant resources. Will be required to work with claim data via Excel.

Required Qualifications
Medical claims processing
Knowledge of Excel
Oral and written communication skills
Technical skills
Analytical skills
Ability to research state documentation

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
QNXT navigation
SQL – ability to run and modify SQL scripts that are already written
Claim processing experience
Understanding of medical terminology
Strong knowledge of benefit plans, policies and procedures

Education
Associate degree or equivalent work experience

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Tagged as: 501+ Employees, Hide US-Only Jobs, Venture Funded