At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
The MED D Financial Analyst, Claims Adjustment role performs claims reverse and reprocessing (R&R) to address benefit coding errors, eligibility changes, program features, and client requests. This reprocessing is a vital step in the Adjustment process. This entails resolving rejects and QA fails, obtaining multiple levels of approvals, and closing out the cases in a timely manner to issue financial impacts to members, clients, and pharmacies. This activity touches millions of claims a year and has wide organizational impacts.
This role is required to manage an individual queue of multiple projects in a fast-paced, process-driven environment. Attention to detail, excellent communication, and time-management skills are essential.
Analysts work closely with multiple internal departments such as Sales, Account Management, IT, Medicare Part D Services, Client Audit, Benefits, and Implementations to manage and coordinate the work.
**Required Qualifications:**
- 1+ years of financial or healthcare experience
- 1+ years of utilizing advanced Excel skills
**Preferred Qualifications:**
- PBM Industry and plan design.
- RxClaim adjudication or benefits knowledge.
- Medicare Part D - PBM or claim adjudication knowledge.
- Proficiency in IBM AS400.
- Understanding of data sets, tables/files, queries, joins, and other database concepts.
- Highly desired Excel skills include ability to manage and present large volumes of data, creating/using complex formulas, report formatting, pivot tables, data manipulation, and other advanced functions.
- Strong customer service focus that includes both internal and external customers.
- Excellent verbal and written communication skills.
**Education:**
- Verifiable Bachelor's degree or equivalent experience required
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$43,888.00 - $93,574.00
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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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We anticipate the application window for this opening will close on: 08/08/2025
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.