CVS Health

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Benefits Setup Rep II

at CVS Health

Posted: 10/7/2019
Job Reference #: 1076709BR
Keywords: benefits

Job Description

Job Description
As a Benefits Setup Rep II, you will be part of an extremely talented team within our Health Plan Client Benefits testing department at CVS Health. You will be responsible for analyzing client requests and performing the necessary benefits testing and quality assurance validation. You will work alongside other Benefits Coders and Testers as well as our Requirements team to deliver high quality support to our vast number of clients. Extreme attention to detail is important for this role, as your testing and quality assurance activities will directly impact our clients’ pricing and their patients’ ability to get medication at the correct price.

As a Benefits Setup Rep II, you will be expected to demonstrate a high level of service through direct interaction with the client and or internal partners that involves accuracy, responsiveness, reliability, and professionalism on every interaction in a fast-paced environment. You will need to positively demonstrate the ability to be flexible and adaptive to change.

For this role you will be responsible for building tests on client intent and then running claim validation for correct copay and drug list, which is 60% of your day.

Required Qualifications
1+ years of professional work experience in Claims, Insurance, QA, Testing, or a high-production environment
1+ years of Microsoft Office applications experience

Preferred Qualifications
- Knowledge of the Pharmacy Benefit Management and/or Health Insurance Industry from an operations perspective
- General understanding of plan benefit design preferred
- Experience working in, RxClaim/AS400

High School Diploma or GED required
Bachelors Preferred

Business Overview
It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. 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. 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. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!