Claim Benefit Specialist

CVS Health

. Review and rework sensitive, complex medical and hospital claims for the rework project department .

Posted 9/15/2026full-timeHartford • Alabama • United StatesJunior💰 $17 - $31 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical and hospital claims processing, with a strong focus on accuracy, compliance, and problem-solving. Proficient in managing multiple priorities while ensuring timely resolution of complex claims.

Highest-signal resume keywords

Medical Claims ProcessingRoot Cause AnalysisAttention to DetailMicrosoft Office ProficiencyHealthcare Operations Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingMedical BillingProblem SolvingData AnalysisRegulatory Compliance

Soft Skills

Strong Communication SkillsOrganizational SkillsAdaptabilityTeam CollaborationTime Management

Tools & Technologies

Microsoft OutlookMicrosoft WordMicrosoft Excel

Industry Keywords

HealthcareInsuranceCustomer ServiceClaims ManagementMedical Terminology

About the role

Key responsibilities & impact

Review and rework sensitive, complex medical and hospital claims for the rework project department
Work closely with Commercial Services Operations team members to perform root cause analysis and precisely resolve affected claims
Ensure rework project claims are resolved accurately
Interface with appropriate areas to address claims
Complete rework project claims by the due date
Serve as a medical/hospital claim processor for rework projects, compliance, and complex issues
Process claims for specific providers/networks or large-scale rework projects resulting from plan sponsor issues, release fallout, and legal, regulatory, or compliance concerns

Requirements

What you’ll need

High School Diploma, GED, or equivalent
1+ year of experience in customer service, administrative support, healthcare, insurance, billing, or a related field
Strong attention to detail with the ability to review information accurately and identify discrepancies
Ability to analyze information, solve problems, and make sound decisions
Strong verbal and written communication skills
Proficiency with Microsoft Office applications, including Outlook, Word, and Excel
Ability to manage multiple priorities in a fast-paced environment while meeting quality and productivity expectations
Preferred: Experience working in healthcare, insurance, claims processing, medical billing, or customer service
Preferred: Knowledge of medical terminology, insurance benefits, or healthcare operations
Preferred: Experience using computer systems to research and resolve customer or claim-related issues
Preferred: Ability to work independently and collaboratively in a team environment
Preferred: Strong organizational and time management skills
Preferred: Demonstrated adaptability and willingness to learn new processes and systems

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being, based on eligibility