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Cvs Claims Jobs (NOW HIRING)

Zurich Insurance Company Ltd.

MN · On-site

$22.40 - $30.87/hr

Zurich is currently looking for a RCIS Crop Claims Field Adjuster I to join our Rural Community ... Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting ...

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Cvs Claims information

See salary details

$30.5K

$64.6K

$90K

How much do cvs claims jobs pay per year?

As of Sep 2, 2026, the average yearly pay for cvs claims in the United States is $64,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,000.00 and $75,500.00 per year, depending on experience, location, and employer.

What are CVS claims?

CVS claims refer to the requests for reimbursement or payment that are processed by CVS Health, typically through its pharmacy benefit management (PBM) services. These claims are submitted by pharmacies or healthcare providers to CVS for prescription drugs or healthcare services provided to patients covered by insurance plans managed by CVS. The claims process involves verifying patient eligibility, ensuring medication coverage, and determining the amount to be paid by the insurer and the patient. Efficient claims processing is essential to ensure timely access to medications and accurate billing for both providers and patients.

What are the key skills and qualifications needed to thrive as a CVS claims specialist?

To thrive as a CVS Claims Specialist, you need a solid understanding of insurance claims processing, attention to detail, and knowledge of healthcare regulations, typically supported by relevant education or experience in insurance or pharmacy benefit management. Familiarity with claims management software, pharmacy systems, and industry-standard coding (such as ICD-10 and CPT) is important. Strong analytical thinking, problem-solving abilities, and effective communication skills help in resolving claim issues and collaborating with team members. These skills ensure accurate claims processing, regulatory compliance, and high-quality service for clients and patients.

What are some common challenges faced by professionals in CVS claims roles, and how can they be addressed?

Professionals working in CVS Claims often encounter challenges such as managing high-volume workloads, navigating complex insurance policies, and ensuring timely and accurate processing of claims. These challenges can be addressed by developing strong organizational skills, staying updated on industry regulations, and utilizing claims management software efficiently. Regular communication with team members and cross-functional departments also helps to resolve discrepancies and streamline workflows, making the process smoother for both employees and clients.

What is the difference between Cvs Claims vs Pharmacy Technician?

AspectCvs ClaimsPharmacy Technician
Required CredentialsHigh school diploma, certification in claims processingHigh school diploma, pharmacy technician certification
Work EnvironmentInsurance companies, claims processing centersPharmacies, healthcare facilities
Industry UsageInsurance and healthcare billingPharmaceutical services and patient support
Common Search IntentClaims processing, insurance reimbursementMedication dispensing, patient assistance

While both roles involve healthcare and require knowledge of medical terminology, Cvs Claims primarily focuses on processing insurance claims and reimbursement, whereas Pharmacy Technicians assist pharmacists with medication preparation and patient service. Understanding these differences helps job seekers identify the right career path in the healthcare industry.

More about Cvs Claims jobs

What states have the most Cvs Claims jobs?

States with the most job openings for Cvs Claims jobs include:

What job categories do people searching Cvs Claims jobs look for?

The top searched job categories for Cvs Claims jobs are:

Cvs Claims jobs near you
Infographic showing various Cvs Claims job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 85% In-person, and 15% Remote job distribution, with an average salary of $64,609 per year, or $31.1 per hour.

Project Manager, Provider Network Contract Validation

CVS Health

Wellesley, MA • On-site

$60K - $159K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 8 hours ago

Posted today

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,359 frontline employees who took The Breakroom Quiz

92nd of 113 rated pharmacies

Job description

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 ourselvesaccountable 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

Dynamic position within the new Network Contract Validation team, responsible for ensuring accurate payment of provider contracts through Health Rules Payor (HRP) a claims processing platform. As part of the Network Contract Validation team, you will be responsible for reviewing, auditing, and coordinating the correction (if necessary) of HRP contract setup against contract intent and evaluate the pricing performance of claims. Accurate provider pricing configuration is critical to claims adjudication, and ultimately, having satisfied consumers and providers. By working closely with other areas of the company such as Network, Provider Data Services, Next Gen Provider Contract/Pricing team, Business Intent Review (BIR), HRP Provider Demographics, HRP Claims, HRP Product, legal/compliance, medical policy, and/or segment leaders this position will be responsible for ensuring the correct decisions were made when configuring contract and pricing features in HRP prior to contract implementation. Additionally, this role may participate with workgroups for process improvement.
Required Qualifications

- Experience with SCM (Strategic Contract Manager) and/or EPDB (Enterprise Provider Database), and/or HRP (Health Rules Payor)

- Project Management

- Basic understanding of Provider Contracting
- Experience with EXCEL and working with large data files is critical.
Preferred Qualifications

- Claims processing experience is desired.

- Experience with Health Rules Payor is desired.

- Proven track record in meeting project milestones and negotiating for resources.

- Proven communication skills both written and verbal.

- Proven ability to affect change/interpersonal skills.

- Knowledge of Aetna's Commercial and Medicare products

- Strong organization skills & time management

- Able to independently resolve problems.

- Ability to handle multiple assignments accurately and efficiently

- Able to interpret data, translate it into meaningful information and draw conclusions
Education

-Bachelor's degree preferred/specialized training/relevant professional qualification

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.00 - $159,120.00

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 fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing 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.

We anticipate the application window for this opening will close on: 09/15/2026

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

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