CVS Health Eligibility Processing Analyst in Irving, Texas

Job Description

CVS Health has an opportunity for an Eligibility Enrollment Processing Analyst within our Eligibility Department. As an Eligibility Enrollment Processor Analyst you will be responsible for maintaining, loading, and troubleshooting client eligibility files to ensure timely and accurate updates to online CVSHealth RxClaim processing system.

Additional responsibilities of an Eligibility Enrollment Processing Analyst include but not limited to the following:

  • Verifying client eligibility loads against expected results

  • Analyzing and process electronic eligibility data files

  • Diagnosing and communicating errors to appropriate personnel

  • Serving as resource for responding to questions or providing research and information for resolution of problems for both internal and external customers

  • Supporting all standard processing requirements

  • Processing ad hoc report requests

  • Knowledgeable of assigned activities involving eligibility processing and quality assurance.

  • Ensure IDCards are processed and sent to printing organization.

  • Understanding of programming, logic, updating and running SQL queries

The group of 6 Processing Analyst have shifts from 7am-6pm, and overnight on-call shift 6pm-7am. The on-call consist of Primary and Secondary shifts. The primary person works all after hrs. activities assigned to the team. After hrs. and weekend shift are 7 days a week, including holidays. The shifts rotate between all Processing Analyst. If you work the weekend on-call, you will receive Monday off. On call shifts both Primary and Secondary are Work From Home shifts.

Required Qualifications

2+ years of experience monitoring systems as well as an understanding of programming logic

Preferred Qualifications

  • Aptitude for working in a detailed, technical environment

  • Strong Computer Skills to include Word, Excel, Access, and Mainframe experience

  • Strong communication skills both verbal and written

  • Strong analytical skills

  • AS400 RxClaim

  • Macro writing/execution experience

Education

  • High School Diploma or GED required

  • Bachelor's degree preferred

Business Overview

CVS Health, 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.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health at mailto:EEO_AA@CVSHealth.com

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/