Develops and executes comprehensive testing processes for system enhancements and new products and processes encompassing all aspects of customer service including claims, enrollment, provider contracts, and benefits administration.
- Responsible for creating and executing defined unit testing processes to provide quality audits for vendor contracts prior to implementation.
- Assists with testing simple system enhancements.
- Prepares and executes a comprehensive test plan and test scripts to provide quality audits for vendor contracts to ensure quality and accuracy is maintained.
-Verifies that system functions according to user requirements and conforms to established guidelines.
- Follows standardized best practices for documenting and executing simple to moderately complex test
- Validates test results, documents discrepancies, and follows through with resolutions to ensure all issues are resolved.
- Reports progress of problem resolution to management.
- Communicates test outcomes to end users for sign-off on the results.
- Serves as liaison between the system end users and the IT team.
- Performs other duties as required.
coordination of benefits, diagnosis coding, and general customer services sources.
- 5+ years related experience in a service center claims processing or managed care operational role.
- Minimum of one year recent and related system processing, payment, and benefits experience, preferably QNXT managed care.
- Excellent verbal and written communication skills.
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.
Please see required qualifications
High School Diploma or equivalent.
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.