Medical Claim Analyst

CVS Health • Salt Lake City, UT • 2d ago

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Working Hours: Monday through Friday btw the hours 9:00am -6:00pm in your time zone of residence. Training schedule will be based on trainer availability and subject to change from working hours.

Inspects and provides accurate claim information to support savings optimization for claims. Responds to customers on benefit inquiries. Maintains customer service standards. Administers policies and procedures for medical cost management. Coordinates support functions for claim adjudication.

What you will do

Executes both routine and non-routine business support tasks for the Medical Claims area under limited supervision, referring deviations from standard practices to managers.

Follows area protocols, standards, and policies to provide effective and timely support.

Reviews provider billing practices to identify trends and cost savings opportunities.

Conducts training programs related to claim billing appropriateness and health plan guidelines for claim processors.

Tests automated code review programs.

Takes direction to execute techniques, processes, and responsibilities.

Required Qualifications

For this role you will need Minimum Requirements

Working knowledge of problem solving and decision making skills

5+ years work experience

Education

High school diploma or equivalent required.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 09/02/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Similar Jobs

Medical Assistant Medical Ongology

Intermountain Health • Murray, UT • 7h ago

Hospital & Medical

Job Description: A Medical assistant has accountability for providing care to patients in an ambulatory clinic setting. This will involve caring for patients with acute and chronic needs. A Medical Assistant will be resp...

7h ago

Go to Apply

Medical Assistant Float Pool

Intermountain Health • Salt Lake City, UT • 7h ago

Hospital & Medical

7h ago

Go to Apply

CNA Mental Health Worker

CommonSpirit Health Mountain Region • West Valley City, UT • 14h ago

Hospital & Medical

USD $17.00/Hr. to USD $22.30/Hr.Welcome to CommonSpirit Health Mountain Region: CommonSpirit Health Mountain Region is committed to building healthier communities, advocating for those who are poor and vulnerable, and in...

14h ago

Go to Apply

PACU Registered Nurse

HCA Healthcare • Salt Lake City, UT • 1d ago

Hospital & Medical

Description Introduction Do you have the career opportunities as a PACU Registered Nurse you want in your current role? We invest in what matters most to nurses like you - at home, at work, and at every stage in your car...

1d ago

Go to Apply

Utilization Management Nurse Consultant

CVS Health • Salt Lake City, UT • 1d ago

Hospital & Medical

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions compan...

1d ago

Go to Apply

Health Information Specialist I - REQ 3763

Datavant • Salt Lake City, UT • 2d ago

Hospital & Medical

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is power...

2d ago

Go to Apply

Clinical Pharmacist Practitioner -Anticoagulation

Veterans Affairs, Veterans Health Administration • Salt Lake City, UT • 2d ago

Hospital & Medical

Summary The Clinical Pharmacist Practitioner (CPP) provides pharmaceutical care to Veterans as a Clinical Pharmacy Practitioner with the highest level of clinical pharmacist privileges and minimal supervision. The CPP wi...

2d ago

Go to Apply

Physician-Chief of Staff

Veterans Affairs, Veterans Health Administration • Salt Lake City, UT • 2d ago

Hospital & Medical

Summary Serve as the Chief of Staff to the Medical Center Director for programs in patient care and research activities for clinical service. Evaluate and mentor various medical programs. Formulate and recommend plans fo...

2d ago

Go to Apply

Medical Assistant

Fresenius Medical Care North America • Salt Lake City, UT • 2d ago

Hospital & Medical

PURPOSE AND SCOPE: The Medical Assistant I performs duties and responsibilities related to patient care in the ambulatory clinic environment. The incumbent displays responsible behaviors, communicates effectively to othe...

2d ago

Go to Apply

Account Manager- Physician Liaison

Doctor Referral Institute • Salt Lake City • 3d ago

Hospital & Medical

Company Description Doctor Referral Institute serves specialty practices in the medical and dental field around the country, providing face-to-face representation with an experienced team and system to referral sources....

3d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.