About the Company
CVS Health is a leading healthcare company that provides a full range of pharmacy and healthcare services, from retail pharmacies to pharmacy benefit management, health plans, and a variety of clinical and disease management programs. We are committed to helping people on their path to better health, focusing on innovation and compassionate care. Join our team and contribute to a healthier future for communities across the nation.
Job Description
We are seeking a dedicated and detail-oriented State/Provincial Disability Claims Processor to join our team in Cranston, Rhode Island. In this rewarding role, you will be responsible for processing disability claims accurately and efficiently, ensuring compliance with state regulations and company policies. This position requires strong analytical skills, attention to detail, and a commitment to providing excellent service to our claimants. You will play a crucial part in supporting individuals through challenging times, making a real impact on their lives.
Key Responsibilities
- Review and process disability claims in accordance with state/provincial laws, federal regulations, and company guidelines.
- Analyze claim information, medical records, and policy terms to determine eligibility and benefit entitlements.
- Communicate professionally with claimants, employers, and healthcare providers to gather necessary documentation and information.
- Maintain accurate and thorough claim records within the system.
- Identify and investigate discrepancies or potential fraud in claims.
- Calculate and authorize appropriate benefit payments.
- Respond to inquiries regarding claim status, benefits, and procedures.
- Collaborate with internal teams, including legal, medical, and customer service, to resolve complex claims issues.
- Stay updated on changes in disability laws, regulations, and industry best practices.
Required Skills
- Strong analytical and problem-solving abilities.
- Excellent written and verbal communication skills.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
- Ability to work independently and manage a high-volume caseload.
- Exceptional attention to detail and organizational skills.
- Demonstrated ability to maintain confidentiality and handle sensitive information.
Preferred Qualifications
- Associate's or Bachelor's degree in a related field (e.g., Business Administration, Healthcare Management).
- Prior experience in claims processing, insurance, or a healthcare administrative role.
- Familiarity with medical terminology and disability assessment processes.
- Experience with claims management software.
Perks & Benefits
- Competitive salary and performance-based bonuses.
- Comprehensive health, dental, and vision insurance plans.
- 401(k) retirement plan with company match.
- Paid time off, including vacation, sick leave, and holidays.
- Employee assistance program and wellness initiatives.
- Opportunities for professional development and career growth.
- Tuition reimbursement program.
- Discounted gym memberships and health programs.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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