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
CVS Health is currently looking for a highly motivated candidate who can effectively and accurately review and rework sensitive, complex medical and hospital claims for our rework project department. They will work closely with other members of the Commercial Services Operations team providing root cause analysis and precise resolution of affected claims. The candidate is responsible for ensuring the rework project claims are resolved accurately, interfaces with appropriate areas, and is handled by the rework project due date.
The candidate will serve as a medical/hospital claim processor for rework projects, compliance, and complex issues for a specific provider/network or large-scale rework projects generated as a result of plan sponsor issues, release fallout and/or legal/regulatory/compliance concerns.
Required Qualifications
- Minimum 1 year of experience in medical claims processing, healthcare billing, revenue cycle operations, or a related healthcare administrative role.
- Strong analytical and problem-solving skills with the ability to research and resolve complex claim issues.
- Proven ability to manage multiple priorities while meeting quality and turnaround time expectations.
- Strong attention to detail and commitment to accuracy.
- Proficiency in Microsoft Excel, including sorting, filtering, and basic data analysis.
- Demonstrated ability to work effectively in a fast-paced environment while adapting to changing business needs.
Preferred Qualifications
- Experience working in healthcare, insurance, claims processing, medical billing, or customer service.
- Knowledge of medical terminology, insurance benefits, or healthcare operations.
- Experience using computer systems to research and resolve customer or claim-related issues.
- Ability to work independently and collaboratively in a team environment.
- Strong organizational and time management skills.
- Demonstrated adaptability and willingness to learn new processes and systems.
Education
High School diploma or equivalent
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$17.00 - $31.30This 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.
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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Skills Required
- Minimum 1 year of experience in medical claims processing, healthcare billing, revenue cycle operations, or a related healthcare administrative role.
- Strong analytical and problem-solving skills with the ability to research and resolve complex claim issues.
- Ability to manage multiple priorities while meeting quality and turnaround time expectations.
- Strong attention to detail and commitment to accuracy.
- Proficiency in Microsoft Excel, including sorting, filtering, and basic data analysis.
- Ability to work effectively in a fast-paced environment while adapting to changing business needs.
- High school diploma or equivalent.
- Experience working in healthcare, insurance, claims processing, medical billing, or customer service.
- Knowledge of medical terminology, insurance benefits, or healthcare operations.
- Experience using computer systems to research and resolve customer or claim-related issues.
- Ability to work independently and collaboratively in a team environment.
- Strong organizational and time management skills.
- Demonstrated adaptability and willingness to learn new processes and systems.
CVS Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.
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Healthcare Strength — Health coverage includes medical, dental, and vision with HSA-eligible options, free preventive care, virtual care, and access to MinuteClinic services. Mental-health resources such as counseling support are emphasized, and coverage is often considered solid for full-time colleagues.
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Retirement Support — A dollar-for-dollar 401(k) match up to 5% after one year and an Employee Stock Purchase Plan are consistently highlighted in Total Rewards materials. Feedback suggests retirement programs are a meaningful strength within the overall package.
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Wellbeing & Lifestyle Benefits — Wellbeing offerings include up to 20 no-cost counseling sessions per issue, backup care, tuition assistance, and substantial in-store discounts, alongside broader wellness tools. These everyday perks expand value beyond base pay and can be especially meaningful for full-time schedules.
CVS Health Insights
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
