CVS Health is seeking a Claims Analyst to join our team. In this role, you will collaborate with Claims Examiners to identify, research, and resolve claims issues, ensuring the timely and accurate adjudication of Service department claims.

What You'll Do

Work with internal and external clients to provide rapid and accurate responses to claims inquiries.
Document current processes and make recommendations to improve and automate manual systems.
Provide guidance and instruction to Examiners and monitor their daily productivity.
Troubleshoot system outages and problems, recommending effective solutions.
Monitor, track, and report on all claims submitted within the systems for processing or review.
Recommend enhancements to systems and processes.
Monitor and allocate tasks deferred to the Claims department, ensuring follow-up and resolution.
Interact with Service Centers and Asurion clients to ensure accurate and timely claims submissions.
Process claims in the appropriate adjudication module, following all Asurion, Insurance, and Client guidelines.
Meet or exceed client and Asurion standards for timeliness, accuracy, and volume.
Utilize all reporting tools available to the Claims team.
Evaluate and direct issues outside the scope of claims to the correct department, following up to ensure resolution.
Communicate education and updates within the Claims Department to ensure team members have the necessary tools.
Work with Customer Service and Management to assist in understanding claims processes.
Assist with documenting all departmental processes and procedures.
Build and maintain a comprehensive claim training manual and reference material catalog.

What We're Looking For

High school diploma or equivalent.
Excellent communication skills, both written and verbal.
PC experience is required.
Demonstrated success in multi-tasking and time management.
Experience with Microsoft Excel is required.
Excellent attendance record.
Proficiency in Word and Outlook.
Superior problem-solving ability, including troubleshooting and process improvement experience.