Senior Claim Data Specialist

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

This is a fully remote position open to any US state.

Joint Claim Administration (JCA) is seeking a Sr Claim Data Specialist to join our reporting team. This role will be responsible for compiling claim data, development and maintenance of structured claim reports, troubleshooting reporting inefficiencies, and providing ad-hoc analysis that supports financial operations and strategic decision making for the JCA book of business.

Responsibilities

• Collects, organizes, and analyzes healthcare data from various sources

• Assists with the upkeep and general maintenance of templates and reporting instructions

• Translates complex data into information and assists users in its interpretation as needed

• Generates reports, dashboards, and performance metrics to track, monitor, and evaluate financial results and operational efficiencies

• Identifies opportunities for process improvement by leveraging data analysis to identify bottlenecks, inefficiencies, and areas for automation

Required Qualifications

• Ability to efficiently manage and execute report creation, manipulation, and delivery with accuracy and attention to detail
• Experience in maintaining detailed documentation of processes essential for knowledge preservation and training.
• Advanced Excel Skills/large data files (e.g. Pivot Tables, VLookups)
• Advanced organization skills & time management.
• 1+ year experience ACAS/EWM claim system

Preferred Qualifications

• Experience in generating, managing, and automating a high volume of reports using tools like Alteryx, VBA, QuickBase.
• Strong verbal and written communication skills
• Self-driven & strong work ethic
• Utilizing available tools to design, implement and maintain solutions, ensuring data quality and addressing any process deficiencies
• Collaborating for Results

Education

• High School diploma, G.E.D. or equivalent experience

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $31.72

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.  
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 02/12/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.