Hispanic Alliance for Career Enhancement
Ops Account-OPS - Coordinator Ii
Hispanic Alliance for Career Enhancement, Hartford, Connecticut, us, 06112
Overview
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. We do it all with heart, each and every day. Position Summary
Employee will support the PIAB Overpayment Recovery Department, in a production and quality environment, by validating claims to determine if they are overpaid based on Aetna Policy and guidelines. Responsibilities
Responsibilities are to be interpreted from the provided description and may include: Validate claims to determine if they are overpaid based on policy and guidelines. Required Qualifications
A minimum of 1+ years QNXT claims experience (reading or processing of claims) Excellent written communication skills Exhibits Heart at Work Behaviors Meeting or Exceeding all scorecard objectives for a rolling 12 months Strong analytical and research skills Preferred Qualifications
Basic experience in Microsoft Applications (Outlook, Excel, TEAMS) Experience in a production/quality environment Experience in OPT, Document Viewer, CEQ, GPS, HRP, QNXT, ACAS Education
High School Diploma or equivalent Disclaimer
This position has a flexible schedule with start times ranging between 5:00 AM and 9:30 AM in your specific time zone. At times, a late day meeting may be scheduled and attendance will be required. Anticipated Weekly Hours
40 Time Type
Full time Pay Range
The typical pay range for this role is: $18.50 - $38.82 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. 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 10/01/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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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. We do it all with heart, each and every day. Position Summary
Employee will support the PIAB Overpayment Recovery Department, in a production and quality environment, by validating claims to determine if they are overpaid based on Aetna Policy and guidelines. Responsibilities
Responsibilities are to be interpreted from the provided description and may include: Validate claims to determine if they are overpaid based on policy and guidelines. Required Qualifications
A minimum of 1+ years QNXT claims experience (reading or processing of claims) Excellent written communication skills Exhibits Heart at Work Behaviors Meeting or Exceeding all scorecard objectives for a rolling 12 months Strong analytical and research skills Preferred Qualifications
Basic experience in Microsoft Applications (Outlook, Excel, TEAMS) Experience in a production/quality environment Experience in OPT, Document Viewer, CEQ, GPS, HRP, QNXT, ACAS Education
High School Diploma or equivalent Disclaimer
This position has a flexible schedule with start times ranging between 5:00 AM and 9:30 AM in your specific time zone. At times, a late day meeting may be scheduled and attendance will be required. Anticipated Weekly Hours
40 Time Type
Full time Pay Range
The typical pay range for this role is: $18.50 - $38.82 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. 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 10/01/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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