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CVS Health Pharmacy Claims Reviewer in Scottsdale, Arizona

Job Description

At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans, and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simply and seamless, to not only help people get well, but help them stay well in body, mind and spirit.The Pharmacy Claims Reviewer is responsible for reviewing pharmacy claims submitted through the CVS Health claims processing systems. The Pharmacy Claims Auditor will identify and rectify claim inaccuracies that would result in client over-payment.In order to be successful in this role you will contact pharmacies for proper documentation to ensure a claim was submitted correctly as well as monitor assigned clients and report status on a regular basis. In the event of an inaccurate claim submission, you will follow the appropriate PoliciesWe offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.

Required Qualifications

-1+ year professional pharmacy experience, preferably in a retail pharmacy or drug data entry position

Preferred Qualifications

  • Pharmacy experience, preferably in a compound pharmacy.- Knowledge of CVS Health (or other Pharmacy Benefit Management) claims processing systems.- Bachelor's Degree preferred.


  • High school diploma or GED required. Bachelor's preferred

Business Overview

At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.