Join to apply for the Claim Audit Quality Specialist role at CVS Health

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.

Position Summary The Quality Specialist will audit pre and post payment claims for accuracy and eligibility transactions. They will also be responsible for identifying errors, necessary corrective measures, and may participate in special audit assignments.

Required Qualifications 1+ years of experience working in a health care setting. 6 months or more interpreting and understanding of plan documents. Knowledge of Microsoft Excel.

Preferred Qualifications 1-2 years claims processing experience. 1-2 years auditing experience. Able to work in a production driven environment, managing multiple tasks while shifting priorities and maintaining a high work volume. Excellent verbal and written communication skills with the ability to interact effectively and courteously. Ability to work with minimal guidance while delivering accurate and timely results. Strong time management, attention to detail, and organizational skills. Team oriented personality.

Education High school diploma or higher.

Anticipated Weekly Hours 40

Time Type Full time

Pay Range The Typical Pay Range For This Role Is

$17.00 - $34.15

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.

Benefits 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

Application Deadline We anticipate the application window for this opening will close on: 10/20/2025

EEO Statement 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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