Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
The primary purpose of the negotiator position is to collaborate with non-par providers to negotiate the pricing of medical and facility claims to obtain the highest possible success rates, resulting in savings for both the member and Aetna.
As a Negotiator Analyst, you will:
- Communicate with providers via phone, fax, and/or email as set forth under the negotiation guidelines.
- Organize and prioritize incoming workload to ensure turn-around time, productivity, and quality metric are met.
- Work to obtain information such as plan benefits, insured liability utilizes basic accounting skills to assist in the negotiation process.
- Handle calls and written inquiries from providers related to pre and post negotiations.
- Review provider history in Global Claim Services (CMS) application to assist in determining appropriate negotiation thresholds.
- Maintain and utilize all resources and systems to effectively manage day-to-day responsibilities.
- Independently review and resolve claim/billing issues and concerns.
Required Qualifications
- Ability to effectively time manage and prioritize tasks.
- Capable of building rapport and making decisions independently.
- Customer Service experience.
- Familiar with Healthcare terminology.
- Proficient written and verbal communication.
- Attention to detail; data entry required.
- Able to perform basic accounting concepts.
Preferred Qualifications
- Medical Billing knowledge.
- Claim Processing experience.
- Possess strong, active listening, patience, adaptability, and persuasion skills.
- Working knowledge of Microsoft Office products (Word, Excel, Outlook) and Internet Explorer.
- General knowledge on negotiation (through medical billing process, claim processing, or other avenues).
- Ability to give clear and concise examples of how to negotiate in a professional setting.
- Possession of an active New York Adjusters License is a plus.
Education
- High School Diploma, G.E.D and equivalent combination of work experience.
Pay Range
The typical pay range for this role is: $40,600.00 - $76,500.00. 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.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies.
We anticipate the application window for this opening will close on: 04/28/2024.
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com. If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
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