Medical Claim Analyst

CVS Health • Alabama, Alabama • 4d ago

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

-Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and redirects misdirects -Responsible for prepping the authorization in the system and triage cases to medical staff for review. -Organized and prioritizes work to meet regulatory and claim turn-around times -Promotes communication, both internally and externally to enhance effectiveness of medical management services and health care team. -Performs non-medical research and support -Adheres to Compliance with PM Policies and Regulatory Standards. -Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. -Protects the confidentiality of member information and adheres to company policies regarding confidentiality. -Assist in the research and resolution of claims payment issue

Required Qualifications

Effective communication, telephonic and organization skills.

Familiarity with basic medical terminology and concepts used in care .

Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.

Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word

Preferred Qualifications

-2-4 years experience as a medical assistant, office assistant or claim processor

-CEC/GPS, or MedCompass

Education

High School Diploma or G.E.D

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $38.82

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 09/30/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

Similar Jobs

Urgent Care Physician

Included Health • Part-time • Alabama • 51min ago

Hospital & Medical

We're looking for a board-certified physician with broad clinical expertise and a passion for improving healthcare access and quality. You'll provide care to patients of all ages across a wide range of conditions, mainta...

51min ago

Go to Apply

Registered Nurse

Worldwide Travel Staffing, Limited • Alabama, Alabama • 1h ago

Hospital & Medical

Worldwide Travel Staffing, Limited has immediate travel nursing opportunities for Registered Nurses in healthcare settings.Equal Opportunity Employer Minorities/Women/Veterans/DisabledIf you require assistance with compl...

1h ago

Go to Apply

Licensed Practical Nurse

Worldwide Travel Staffing, Limited • Alabama, Alabama • 1h ago

Hospital & Medical

Worldwide Travel Staffing, Limited has immediate openings for Licensed Practical Nurses interested in travel nursing assignments in healthcare settings.Equal Opportunity Employer Minorities/Women/Veterans/DisabledIf you...

1h ago

Go to Apply

Clinical | Travel:Registered Nurse (RN) / Medical Surgical - Contract - Days

HealthTrust Workforce Solutions • Alabama, Alabama • 1d ago

Hospital & Medical

Grow Your Career with HealthTrust & Community Health System (CHS) Looking to expand your nursing career in a new location? HealthTrust Workforce Solutions has partnered with CHS to provide travel nurse opportunities...

1d ago

Go to Apply

Emergency Vehicle Dispatcher

Army Tank-Automotive and Armament Command (TACOM) • Alabama, Alabama • 2d ago

Hospital & Medical

Summary This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Domestic Defense Industrial Base (DIB) and Major Range & Test Facilities Base (MRTFB) in DoD to recruit and appoint qualified candidate...

2d ago

Go to Apply

AIS Radiologist (Remote)

Antech Diagnostics • Alabama, Alabama • 2d ago

Hospital & Medical

We understand that the world we want tomorrow starts with how we do business today, and that's why we're inspired to make A Better World for Pets. Antech is comprised of a diverse team of individuals who are committed to...

2d ago

Go to Apply

Restaurant General Manager

Shake Shack • Alabama, Alabama • 3d ago

Retail & Hospitality

5348 Highway 280 Birmingham, AL 35223 Full time JR13421 Our secret to leading the way in hospitality? We put our people first! At Shake Shack, our mission is to Stand For Something Good in all that we do. From our teams...

3d ago

Go to Apply

2027 Summer Intern: Supply Chain

PepsiCo North America Beverages • Alabama, Alabama • 5d ago

Manufacturing & Warehouse

OverviewSMILE AT WHAT'S NEXTAt PepsiCo, you'll find the opportunity to grow your career, make an impact, and help shape what's next. As one of the world's leading food and beverage companies, our beloved brands-including...

5d ago

Go to Apply

Sr. Data Scientist (Remote)

CrowdStrike • Alabama, Alabama • 5d ago

IT & Engineering

USA - Remote USA - Remote, WY Canada - Remote NS Canada - Remote NB Canada - Remote BC Canada - Remote AB Canada - Remote, MB USA - Remote, WI USA - Remote, WV USA - Remote, WA USA - Remote, VA USA - Remote, VT USA - Rem...

5d ago

Go to Apply

2027 Summer Intern: Strategic Finance- MBA

PepsiCo North America Beverages • Alabama, Alabama • 5d ago

Finance, Accounting & Banking

Job DescriptionOverviewSMILE AT WHAT'S NEXTAt PepsiCo, you'll find the opportunity to grow your career, make an impact, and help shape what's next. As one of the world's leading food and beverage companies, our beloved b...

5d ago

Go to Apply

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