Senior Claim Benefit Specialist - Stop Loss, CVS Health

Senior Claim Benefit Specialist - Stop Loss

CVS Health

Location:

United States, Plymouth

Category:

Customer Service

Contract Type:

Employment contract

Salary:

18.50 - 38.82 USD / Hour

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Job Description:

This role provides exposure to aspects of healthcare claims administration including reinsurance/stop loss, data analytics, provider and broker relations, underwriting, eligibility, finance, and client management. Develop and hone skills such as critical thinking, problem-solving, superior organization, and effective communication. Extensive training and a promising career path are provided for candidates.

Job Responsibility:

Act as an important liaison and subject matter expert between internal and external stakeholders and stop loss administrators
Manage stop loss claim filings
Reconcile and resolve discrepancies between the amount requested and the amount reimbursed by the stop loss carrier

Requirements:

Minimum of 1 year of experience in healthcare claims processing
Minimum of 2 years of experience with the suite of Microsoft applications (particularly Excel)
Ability to work independently across a matrix team in a fast-paced environment
Strong interpersonal and communication skills (verbal and written) and pride in your work

Nice to have:

Experience in stop loss administration
Exposure to a mainframe IBM AIX or AS/400 environments (i.e. 'green screen', command driven platforms)

What we offer:

Medical, dental, and vision benefits
Eligible 401(k) retirement savings plan
Employee Stock Purchase Plan
Fully-paid term life insurance plan
Short-term and long-term disability benefits
Numerous well-being programs
Education assistance
Free development courses
CVS store discount
Discount programs with participating partners
Paid Time Off ('PTO') or vacation pay
Paid holidays

Additional Information:

Job Posted:

March 19, 2025

Expiration:

April 23, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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