As a Benefits Coding Advisor, you will be responsible for queue management, performance guarantee tracking and daily monitoring for compliance of case submission. You will be developing reporting strategies, coordination of cross functional teams, driving solutions and providing tactical and strategic direction for delivery of work. You will be responsible for performance guarantee reporting and conducting root cause analysis and action plans for missed key performance indicators. In this role you will also mentor the junior project team members to ensure a successful Welcome Season and for all maintenance of business activities for new and existing clients. You will accomplish this by:
- Validating, configuring, maintaining, implementing and communicating the benefit plan design additions and changes
- Analyzing, interpreting and comprehending complex client benefits requirements, commitments and contracts
- Building and maintaining relationships with clients, test centers of excellence, benefit coding teams and account management teams
As a Benefits Coding Advisor, your success will be driven by exceeding client satisfaction score targets as well as contributing to reduced service warranty payments to clients. Your healthcare industry knowledge, RX Claim/AS400 Coding experience and process improvement skills will also contribute to your success. You will operate in a fast-paced environment with tight deadlines so ability to operate autonomously and make key decisions is imperative. The contributions you will make will position CVS Health as a leader in client satisfaction and service in the PBM marketplace.
* 5 or more years of leading benefits projects including 4 or more years of benefit coding experience in AS400/RxClaim system
* Willingness and ability to travel up to 10%
* Dynamic individual contributor that thrives in a fast-paced, operational environment that is client centric
* Demonstrated ability to make decisions independently by applying sound judgment based on business principles
and supporting data facts
* Strong interpersonal communication and presentation skills
* Positive "can do" attitude with focus on the success of the team and Welcome Season efforts
* Possesses strong organizational and time management skills, and attention to detail and demonstrated ability to be accountable and independent
* Advanced Microsoft Excel skills for data analysis and Macro development
* Bachelor's degree is required; equivalent work experience may substitute
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/
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