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Representative II Benefits Setup

Company: CVS Health
Location: Irving
Posted on: May 3, 2021

Job Description:

Job Description

The Client Benefit Representative II will analyze client benefit requests, determine best operational approach and perform coding. This employee will also validate coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. The Client Benefit Representative II will be responsible for meeting or exceeding turnaround time and quality standards as well as researching client benefit requests/issues and recommending alternative solutions to internal partners in meeting client needs.

In addition to coding, this position will also be responsible performing QA functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timelines. This position may support coding, testing and QA activities for commercial clients as well as clients with federal/state programs (such as Medicare D, Medicaid, MAPD, RDS, COB, EGWP, HealthCare Reform, etc.)

Required Qualifications

  • 2 + years experience within a Healthcare, Pharmacy Benefit Management or Pharmacy environment
  • 2+ years experience with AS400/RXclaim

Preferred Qualifications

Previous coding experience

Education

Bachelor's degree in any discipline is preferred

Education

High School Diploma or GED required

Business Overview

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.

Keywords: CVS Health, Irving , Representative II Benefits Setup, Other , Irving, Texas

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