CVS Health is seeking a Senior Claims Benefit Specialist to join its Customer Care team in a fully remote capacity, available in multiple U.S. states. This role offers an opportunity to contribute to the company’s mission of delivering connected, convenient, and compassionate healthcare.
Role Overview
The Senior Claims Benefit Specialist is responsible for reviewing and adjudicating complex and sensitive medical claims in compliance with CVS Health’s processing guidelines. The position serves as a subject matter expert, offering guidance and training to junior staff while resolving advanced claim issues. In addition to claims adjudication, the role includes handling inquiries, overseeing daily work distribution among team members, and ensuring adherence to compliance standards and company policies.
Qualifications and Requirements
Required:
- At least 2 years of medical claim processing experience.
- 1–2 years working in a production- or metrics-based environment.
- Demonstrated ability to manage multiple assignments accurately and efficiently.
- High school diploma (or equivalent).
Preferred:
- Associate degree or equivalent work experience.
- Experience with self-funded plans.
- Familiarity with DG claims system.
This full-time position entails a standard 40-hour workweek and is open to candidates in a range of U.S. states, including Minnesota, Florida, Texas, and Washington, among others.
Compensation and Benefits
The pay range for this role is $18.50–$38.82 per hour, based on factors such as experience, education, and location. Employees are also eligible for CVS Health’s bonus and incentive programs.
Benefits are designed to support physical, emotional, and financial well-being. Highlights include:
- Affordable medical plans, 401(k) with company match, and an employee stock purchase plan.
- Paid time off, flexible schedules, family leave, and dependent care resources.
- Free wellness programs, confidential counseling, and financial coaching.
- Tuition assistance and retiree medical options (eligibility-dependent).
A full benefits overview is available at CVS Health Careers.
Career Growth and Company Culture
At CVS Health, employees work in a culture centered on inclusion, belonging, and professional growth. The company values diverse teams that reflect the communities they serve. Opportunities to mentor others, take on new challenges, and advance into leadership roles are integral to this position. CVS Health promotes a supportive environment where colleagues are empowered to make meaningful contributions every day.
About CVS Health
CVS Health is a leading health solutions company dedicated to improving access, lowering costs, and enhancing health outcomes for millions of Americans. Through its national network of retail locations, digital platforms, and more than 300,000 employees, the company delivers care where, when, and how people need it. Every initiative is approached with a focus on compassion and connection — staying true to its mission to build a healthier world.
For more details or to apply before the application window closes on July 21, 2025, visit the official CVS Health careers page.