Claim Audit Quality Specialist

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 Claim Audit Quality Specialist is responsible for ensuring the accuracy and quality of claim audits across multiple areas within Meritain. This role demands a deep understanding of claims, plan documents, eligibility, coverages, and the unique requirements of various groups. The analyst will become a subject matter expert, applying detailed review skills and maintaining high standards in a fast-paced, high-production environment. Required Qualifications 1+ years of auditing and/or claims processing experience 1+ years of Microsoft Office experience Knowledge of CPT codes Knowledge of ICD-10 codes Preferred Qualifications 1+ years of DG experience 2+ years of claims processing/auditing experience Exceptional attention to detail Ability to quickly become a subject matter expert in new areas Proven track record of managing workload efficiently in a high-volume environment Self Funded claim knowledge a plus Education High school diploma or GED Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $34.15 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 t...