Representative II Benefits Testing

Company: CVS Health
Location: Scottsdale
Posted on: June 12, 2021

Job Description:

Job Description

We are looking for passionate, driven people who want to join a high energy and growing team that will make a difference in our customers' lives and who is willing to work on the Client Implementations and Process Improvements.

This is a Representative II position within the Essential clients Testing department. This individual will support Testing and work with our internal customers along with other job duties as required. This Representative II will need to identify the best approaches and strategies for ensuring the accuracy of Benefit and clinical Testing and could be requested to discuss test results with leads across multiple lines of business.

This Representative II will work as team Member for Benefit and Clinical Testing team, which will include running queries, Claims and analyzing testing defects either within the TCoE department or with our Internal Customers. This individual will need to successfully engage internal business partners and leaders as needed; to resolve issues, drive results and meet project target dates as required by management.

This individual will work with Client Benefits, Account Management and Implementation management along with senior leadership to improve the overall Quality of the Client Implementation experience.

Required Qualifications

• 2+ years' experience in Healthcare
• Ability to run the EzTest Tool and analyze the data spreadsheets
• Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access.

Experience with Visio, Project also a plus.

Preferred Qualifications

• Firm understanding of Federal and State agencies and their role in Healthcare legislation.
• Firm understanding of Healthcare documentation and resource requirements.
• Deep knowledge in Health Plan benefits structures.
• Experience with SQL and Queries is preferred.
• Thorough and detailed knowledge of investigating, analyzing and effecting corrective action using experience to apply various methods and techniques that promote timely change and accountability.
• Strong analytical skills and attention to detail. Ability to define problem, collect data, establish facts, and draw valid conclusions.
• Knowledge and experience with Clinical Operations in the Medicare Part D environment.

Ability to research, analyze and interpret CMS rules and regulations, then apply them to current work assignments.

• Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access
• Knowledge of RxClaim (AS400), EZQuery and EZTest tools

Education

Bachelor's degree required; equivalent work experience may substitute.

Business Overview

At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Keywords: CVS Health, Scottsdale , Representative II Benefits Testing, Other , Scottsdale, Arizona