Medical Claims Analyst

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. A Brief Overview Supports cost management programs to reduce medical claim expense and identify and recover medical claim expense dollars from liable parties. Gathers data and compiles cost analyses to identify cost-saving opportunities and cost reduction strategies to achieve financial goals. What you will do Performs reviews and processing of claims to insurance carriers for payment to ensure accurate and timely claim submissions, helping patients receive the care they deserve. Maintains, enters, and organizes all claims reporting, communications, and discovery on claims in the claims drive or a claims administrative system to ensure industry-proven best practices are instilled within the company's strategies and end product offerings. Conducts analysis and conflict resolution to identify any errors or inconsistencies on initial claims submissions, ensuring claims are error-free and promptly resolved. Handles correspondence, claims, and referrals in the established timeframes and performance guarantees to ensure a high level of customer satisfaction and loyalty. Drafts first notice of claims, preservation of evidence letters, and email holds for litigation holds. Provides communication to and from Operations and other support departments for escalation of service-impacting issues. Prepares presentations and proposals to internal and external clients to successfully enhance the company's brand recognition and competitive advantage in the industry. Evaluates methods/processes after listening to customers and gathering feedback to p...