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Remote Cvs Health Claims Benefits Specialist Jobs

Revecore Technologies

Health Claims Specialist

$17.50/hr

Our medical, dental, vision, and life insurance benefits are available from the first day of ... Health Claims Specialist As a Health Claims Specialist at Revecore, you will bill and investigate ...

Revecore

Health Claims Specialist

Franklin, TN · Remote

$17.50/hr

Our medical, dental, vision, and life insurance benefits are available from the first day of ... Health Claims Specialist As a Health Claims Specialist at Revecore, you will bill and investigate ...

Revecore

Health Claims Specialist

Franklin, TN · Remote

$17.50/hr

Our medical, dental, vision, and life insurance benefits are available from the first day of ... Health Claims Specialist As a Health Claims Specialist at Revecore, you will bill and investigate ...

Revecore Technologies

Health Claims Specialist

$17.50/hr

Our medical, dental, vision, and life insurance benefits are available from the first day of ... Health Claims Specialist As a Health Claims Specialist at Revecore, you will bill and investigate ...

Sutherland

Health Claims Specialists

Louisville, KY · On-site +1

$13.50/hr

Company Description This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much money will be paid after an insurance claim has been examined. This ...

Zenith American Solutions, Inc.

Benefits Specialist

Administer and manage group health, dental, vision, life, disability, and 401(k), including complex ... Respond to employee inquiries regarding benefits eligibility, plan provisions, claims and coverage ...

Apex Systems

Apex Systems is hiring a Benefits Specialist for a large Healthcare client. Location: Fully remote but NCAL preferred. Employment Type: 6 months contract with possibility to extend. Role Overview We ...

TEEMA

Claims Reviewer

Phoenix, AZ · Remote

$26.40 - $27.88/hr

Role : Conduct retrospective review of medical, surgical, and behavioral health claims. * Focus ... Evaluate claims for medical necessity, appropriateness, and adherence to program benefits.

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How much do remote cvs health claims benefits specialist jobs pay per hour?

As of May 28, 2026, the average hourly pay for remote cvs health claims benefits specialist in the United States is $23.50, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $25.72 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote CVS Health Claims Benefits Specialist, and why are they important?

To thrive as a Remote CVS Health Claims Benefits Specialist, you need a solid understanding of healthcare benefits, claims processing, and relevant medical terminology, usually supported by experience in insurance or healthcare administration. Familiarity with claims management software, CRM systems, and HIPAA compliance is typically required, and certifications in medical billing or coding can be advantageous. Strong attention to detail, problem-solving skills, and effective communication are essential for navigating complex claims and supporting customers remotely. These skills ensure accurate claims handling, regulatory compliance, and high-quality service for CVS Health members.

How does a Remote CVS Health Claims Benefits Specialist typically collaborate with other teams while working remotely?

As a Remote CVS Health Claims Benefits Specialist, collaboration is primarily conducted through digital channels such as email, instant messaging, and virtual meetings. You'll regularly interact with colleagues in customer service, pharmacy, and clinical teams to resolve complex claims issues and ensure accurate benefits processing. Clear communication and timely updates are essential, as you'll often need to coordinate on cases that require input from multiple departments. Despite being remote, you'll have access to robust support systems and regular team check-ins to stay aligned with company protocols and goals.

What does a Remote CVS Health Claims Benefits Specialist do?

A Remote CVS Health Claims Benefits Specialist is responsible for reviewing, processing, and resolving healthcare claims for insurance benefits. They analyze claims data, verify eligibility, ensure compliance with company policies, and communicate with members and providers to resolve issues. Working remotely, they use specialized software to process claims efficiently while maintaining a high level of accuracy and customer service. This role is crucial in ensuring that members receive the benefits they are entitled to and that claims are handled in a timely manner.

What is the difference between Remote Cvs Health Claims Benefits Specialist vs Remote Cvs Health Customer Service Representative?

AspectRemote Cvs Health Claims Benefits SpecialistRemote Cvs Health Customer Service Representative
Primary RoleHandles claims processing, benefits verification, and benefits-related inquiriesProvides general customer support, assists with account questions, and resolves service issues
Required SkillsKnowledge of insurance claims, benefits policies, and healthcare terminologyStrong communication skills, customer service experience, and problem-solving abilities
Work EnvironmentMostly administrative, focused on claims and benefits systemsCustomer interaction via phone, email, or chat
Common CertificationsHealthcare or insurance-related certifications often preferredCustomer service or communication certifications beneficial

While both roles support healthcare consumers, the Claims Benefits Specialist focuses on claims processing and benefits management, requiring healthcare knowledge. The Customer Service Representative handles general inquiries and customer support, emphasizing communication skills. Understanding these differences helps job seekers identify the right position based on their skills and career goals.

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Remote Cvs Health Claims Benefits Specialist jobs near you
Behavioral Health Claims Specialist

Behavioral Health Claims Specialist

Threshold Billing Solutions

Sandy, UT • Remote

Full-time

Posted 11 days ago

Job description

Threshold Billing Solutions is actively seeking a motivated and detail-oriented Claims Specialist to join our Claims and Verification of Benefits team.

This role is crucial in analyzing and following up on behavioral health claims to ensure timely and appropriate reimbursement.

As a Claims Specialist, you will serve as an advocate for behavioral health facilities, managing the full claims lifecycle, including submission, follow-up, denial resolution, and verification of patient eligibility.

Key Responsibilities:
  • Claims Management: Handle the submission, status updates, and resolution of Commercial, Medicaid, and Government behavioral health claims.
  • Claim Status Tracking: Ensure timely follow-up on submitted claims, meeting established productivity goals.
  • Denial Resolution: Identify and resolve denied or rejected claims, providing feedback on recurring issues to improve processes.
  • Medical Records Submission: Collect and submit medical records to insurance companies as needed.
  • Patient Eligibility Verification: Confirm coverage for new patients and communicate eligibility statuses.
  • Collaboration: Work closely with behavioral health facilities, insurance companies, and credentialing departments to resolve billing inquiries.

Qualifications:
  • Experience with insurance claims for behavioral health, including Medicaid and Commercial payers.
  • Ability to maintain detailed notes and adhere to HIPAA regulations.
  • Strong communication and problem-solving skills.
  • Familiarity with online clearinghouses and claims software is a plus.

Join a company that values teamwork, integrity, and professional growth. Apply today to become part of a team that makes a difference in behavioral health care.

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