Claims Processor RMT Operations Specialist
CVS Caremark - Scottsdale, AZ

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Job Category: Customer Service
Clinical Licensure Required : N/A

Job Type: Full Time Position Summary:
  • Perform claim batch transactions for Medicare Part D utilizing RxClaim and other systems.
  • Support the RMT Process team in expediting claims processing for escalated issues.
  • Extract different kinds of reports from systems for the RMT Process team.
  • Handle a dynamic workload, balancing routine tasks with special projects and escalated issues.
  • Interface with management and/or IT personnel to help solve technical problems.
  • Be able to accurately track assignments and deliver them in a timely fashion. Required Qualifications:
  • Well organized with the ability to effectively prioritize work * Ownership and results driven * Attention to detail * Focused and thorough research skills * Customer focused * Aptitude for basic and analytical mathematics * Able to handle high volume receipts within defined turnaround times coupled with excellent quality * Proficient use Microsoft Office applications, e.g. Excel, Word * Ability to effectively work within a team * Flexible in adapting to change * Demonstrated ability to analyze data and determine conclusions * Ability to learn and apply increasingly complex concepts, policies and procedures * Ability to effectively plan, prioritize, organize time and workload * Skilled in identifying and solving issues and recommending process improvements * Ability to work successfully in a deadline-oriented environment * Excellent verbal and written communication skills Desired * Thorough understanding of Caremark system applications * Knowledge of healthcare industry * Knowledge of claim adjudication principles * Good understanding of Medicare Part D CMS guidance and Sarbanes Oxley practices Preferred Qualifications:
  • 0-3 years of related work experience required Education:
  • Bachelor's Degree required or equivalent experience. Two years of experience for every year of college not attained. Business Overview:
CVS Caremark, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

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CVS Health is a pharmacy innovation company helping people on their path to better health. Through our 7,800 CVS/pharmacy retail pharmacies,...