Portsmouth, Rhode Island

Job Description
The Client Benefit Representative II will analyze client benefit requests, determine best operational approach and perform coding. This employee will also validate coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. The Client Benefit Representative II will be responsible for meeting or exceeding turnaround time and quality standards as well as researching client benefit requests/issues and recommending alternative solutions to internal partners in meeting client needs.

In addition to coding, this position will also be responsible performing QA functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timelines. This position may support coding, testing and QA activities for commercial clients as well as clients with federal/state programs (such as Medicare D, Medicaid, MAPD, RDS, COB, EGWP, HealthCare Reform, etc.)

Required Qualifications
- 2 + years experience within a Healthcare, Pharmacy Benefit Management or Pharmacy environment
- 2+ years experience with AS400/RXclaim

Preferred Qualifications
Previous coding experience

Education
Bachelor's degree in any discipline is preferred
Education
High School Diploma or GED required

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. See Job Description

Portsmouth, Rhode Island

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses

 

"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."

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