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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Senior Claim Data Specialist acts as a source of information for Oral Surgery processors and customer service representatives. Responsibilities include assisting CSRs with complex calls, handling escalations, coaching, and collaborating across multiple departments. Critical thinking and strong problem-solving skills are required.

Subject matter expert for workflows, policies, components of systems and daily operations and programs

Use analytical and statistical techniques and tools to plan and perform research and analysis of processes.

Report results and make recommendations (e.g., training needs, quality controls and procedures).

In partnership with business owners, support the design and development of new processes.

May provide guidance or expertise to staff.

Facilitate team sessions to develop processes and/or resolve issues.

Support the creation of communication strategies and presentation for both internal and external customers to educate and address continuous quality improvement initiatives.

Analyze and resolve complex claim scenarios within established time frames.

Analyze customer feedback and other measures.

Required Qualifications

1-2 Years Oral Surgery knowledge

2+ Years Experience in Oral Surgery Claims and Customer Service

Outstanding claim processing, customer service skills and dedication to providing exceptional customer care

Strong communication skills, both written and verbal

Ability to multitask and operate in fast paced, team environment

Excellent organizational ability

Preferred Qualifications

Critical thinking

Proficient in utilizing resources to resolve complex issues

Detail oriented

Conflict resolution skills

Education

High School Diploma requiredPay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 01/10/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.