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CVS Health

Medical Claims Analyst

CVS Health

. Execute routine and non-routine business support tasks for the Medical Claims area under limited supervision .

Posted 10/8/2026full-timeRemote • Texas • United StatesMid-LevelSenior💰 $19 - $35 per hourWebsite

Core Competencies

Role fit
Core Competencies

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Demonstrates expertise in medical claims processing, including billing practices and cost management, while providing effective customer support and training. Proficient in problem solving and decision making within the medical claims domain.

Highest-signal resume keywords
Medical Claims ProcessingBilling Practices ReviewCost ManagementCustomer Service StandardsTraining Program Administration

ATS Keywords

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Applicant Tracking System Keywords

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Soft Skills
Problem SolvingDecision Making
Industry Keywords
Claim AdjudicationHealth Plan GuidelinesSavings OptimizationBusiness Support TasksProtocols and Standards

About the role

Key responsibilities & impact
  • Execute routine and non-routine business support tasks for the Medical Claims area under limited supervision
  • Follow area protocols, standards, and policies to provide effective and timely support
  • Review provider billing practices to identify trends and cost savings opportunities
  • Conduct training programs related to claim billing appropriateness and health plan guidelines for claim processors
  • Test automated code review programs
  • Execute techniques, processes, and responsibilities as directed
  • Inspect and provide accurate claim information to support savings optimization for claims
  • Respond to customers on benefit inquiries
  • Maintain customer service standards
  • Administer policies and procedures for medical cost management
  • Coordinate support functions for claim adjudication

Requirements

What you’ll need
  • Working knowledge of problem solving and decision making skills
  • 5+ years work experience
  • High school diploma or equivalent required

Benefits

Comp & perks
  • CVS Health bonus, commission or short-term incentive program in addition to base pay
  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Other resources supporting physical, emotional, and financial well-being