Senior Claim Benefit Specialist- HYBRID SCHDULE

Job DescriptionAs an admin for the Medical Review Department the candidate would primarily be responsible for entering medical records requests, setting and completing follow-ups for pending requests, sending letters to policyholders/beneficiaries requesting forms or information as needed to complete medical records requests and being logged into the phone queue to answer questions about claims in Medical Review.Required QualificationsHYBRID SCHEDULE; 2 days in office required 1-3 years Office Management OR 1-3 years Claims Experience Medical KnowledgeMedical Office work/ knowledge Able to work multiple computer systems, analytical skills, able to research and read policy language and work in a production environment.COVID RequirementsCOVID-19 Vaccination RequirementCVS 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 QualificationsPrevious administrative skills, Knowledge of medical terminologyEducationHS Diploma or HigherBusiness OverviewAt 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.

Created: 2025-10-04