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Cvs Medical Claims Processing Jobs (NOW HIRING)

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This role ensures claims are processed in compliance with payer requirements and organizational ... Submit medical claims (electronic and manual) to insurance carriers, Medicaid, and managed care ...

Urgent

Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Examiner Responsibilities: - Submit claims ...

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Examiner Responsibilities: - Submit claims ...

Patient Support Medical Claims Processing Representative Contract Remote Role - Location (Open to Remote US) As the only global provider of commercial solutions, IQVIA understands what it takes to ...

... processing health plan claims and supporting provider inquiries. Key Requirements Recent medical ... claims experience REQUIRED Experience with medical claims adjudication Knowledge of Medicaid and ...

Medical Claims Examiner, Tucson, AZ The responsibilities of the Medical Claims Examiner consist of processing claims data and adjudicating medical and inpatient claims received from all provider ...

... processing health plan claims and supporting provider inquiries. Key Requirements Recent medical ... claims experience REQUIRED Experience with medical claims adjudication Knowledge of Medicaid and ...

... processing health plan claims and supporting provider inquiries. Key Requirements Recent medical ... claims experience REQUIRED Experience with medical claims adjudication Knowledge of Medicaid and ...

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

Claims Reviewer

Phoenix, AZ · Remote

$26.40 - $27.88/hr

Work closely with medical directors, providers, peer reviewers, and various internal teams. Key Responsibilities * Review and validate claims using established criteria and processing guidelines.

Imagenet LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency. Our core mission ...

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Cvs Medical Claims Processing information

What is the difference between Cvs Medical Claims Processing vs Medical Billing Specialist?

AspectCvs Medical Claims ProcessingMedical Billing Specialist
CredentialsKnowledge of insurance policies, claims processing softwareCertification in medical billing or coding often preferred
Work EnvironmentHealthcare facilities, insurance companies, or outsourcing companiesMedical offices, clinics, or billing companies
Industry UsagePrimarily in insurance claims and healthcare reimbursementInvolved in billing, coding, and invoicing for healthcare providers

Both roles involve handling healthcare financial transactions, but Cvs Medical Claims Processing focuses on submitting and managing insurance claims, while Medical Billing Specialists handle invoicing and coding for patient services. Understanding these differences helps job seekers target the right position in the healthcare revenue cycle.

More about Cvs Medical Claims Processing jobs
Medical Claims Specialist

Medical Claims Specialist

Connecticut Counseling Centers, Inc

Waterbury, CT • On-site

Urgent

$17 - $24/hr

Temporary

Posted 2 days ago

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Job description

Immediate hire!! This is a temp position that could become permanent.


Position Summary
The Medical Claims Specialist is responsible for the accurate and timely submission, tracking, and resolution of medical claims for services. This role ensures claims are processed in compliance with payer requirements and organizational policies, while maximizing reimbursement and maintaining excellent customer service.


Key Responsibilities

  • Submit medical claims (electronic and manual) to insurance carriers, Medicaid, and managed care organizations
  • Review Explanation of Benefits (EOBs) and Remittance Advices; investigate and resolve denials
  • Correct and resubmit claims in accordance with payer guidelines and timelines
  • Monitor accounts receivable, including aged balances and open claims, and follow up to ensure payment
  • Manage appeals processes and pursue reimbursement through all available channels
  • Ensure accuracy and compliance of all claim submissions (including CMS forms and ANSI837 standards)
  • Post payments accurately to patient accounts
  • Maintain payer contact information and stay updated on billing requirements
  • Work to ensure claims are resolved within established timeframes
  • Provide professional and responsive service to internal and external stakeholders


Qualifications & Skills

  • Knowledge of medical billing, claims processing, and insurance procedures
  • Familiarity with electronic claims submission standards (e.g., ANSI837, HIPAA compliance)
  • Strong attention to detail and ability to manage multiple claims and deadlines
  • Analytical and problem-solving skills for denial resolution and accounts reconciliation
  • Effective communication and customer service skills
  • Ability to work independently and collaboratively

Company Description

Connecticut Counseling Centers, Inc. is a not-for-profit corporation that provides a full range of licensed outpatient substance abuse and mental health prevention, education, and treatment services to assist adults in becoming productive members of society.