Benefit Setup Representative
- Irving, TX
This is a Representative I position within the Testing department. This individual will support Testing and work with our internal customers along with other job duties as required. This Representative I will need to identify the best approaches and strategies for ensuring the accuracy of Benefit and clinical Testing across multiple lines of business. This Representative I will work as team Member for Benefit and Clinical Testing team, which will include running queries, Claims and analyzing testing defects either within the TCoE department or with our Internal Customers and will need to successfully engage internal business partners and leaders as needed; to resolve issues, drive results and meet project target dates as required by management.
- 6 + Months Claim testing and Query validation on RX Claims.
-1 year experience in Healthcare or a PBM desired.
-Excellent communication (Verbal and Written) and collaboration skills.
-Courteous and professional demeanor with the desire and ability to work as a team.
-Ability to interact and with project leads and SME's.
-Deep knowledge in Health Plan benefits structures.
-Experience with SQL and Queries is preferred.
-Strong analytical skills and attention to detail. Ability to define problem, collect data, establish facts, and draw valid conclusions.
-Ability to research, analyze and interpret requirements and apply to current work assignments.
-Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access
-Knowledge of RxClaim (AS400), EZQuery and EZTest tools.
-Demonstrate ability to analyze data, verify accuracy and determine conclusions
-Ability to run the EzTest Tool and analyze the data spreadsheets
-Working knowledge of Microsoft Office applications including -Word, Excel, Power Point and Access.
-Bachelor's degree desired; equivalent work experience may substitute.
At CVS Health, 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 strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. 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.
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