CVS Health Professional and Druggist Liability Adjuster in Cumberland, Rhode Island
This position is accountable for the investigation, negotiation, and resolution of MinuteClinic concerns and non-litigated General Liability Pharmacy claims.
This position also is responsible for the budgetary considerations in setting reserves, including bodily injury. Also responsible for the processing and maintenance of dispensing incident reports both written and electronic. This job requires extensive interaction with internal departments, management, field employees, and customers to ensure
timely handling and resolution of claims.
In this job as a Professional and Druggist Liability Adjuster, you will:
· Be responsible for the administrative duties of the EPIC and on-line pharmacy reporting system.
· Review incoming incident reports both written and on-line for exposure.
· Act as point person for field, Risk Management Pharmacy Team and to handle all inquiries, questions, etc. relating to MinuteClinic concerns and pharmacy dispensing incidents.
· Identify claims and potential high exposure cases for referral to appropriate individuals within Risk Management.
· Follow-up on Customer Service complaints and pharmacy incident reports with field personnel.
· Work with field personnel to handle and resolve situations involving dispensing incidents, evaluating small claims and extending settlement authority.
· Review/interpretation of medical reports to determine causal relationship and assist in evaluation of a claim.
· Evaluate and negotiate settlements with customers and/or their attorneys on behalf of CVS.
· Processing settlement releases and issuing settlement checks.
· Review and dissemination of attorney letters, summons, etc. regarding pharmacy-dispensing incidents.
· Maintain and purge written pharmacy incident reports as directed in a retrievable fashion.
- 2 or more years of customer service experience
· Prior insurance experience (claim handling) preferred.
· Data entry experience preferred.
· Superior written and verbal communication skills.
· Exceptional analytical skills with attention to detail.
· Proven ability to handle conflict successfully.
· Ability to maintain work in strictest confidence.
· Ability to prioritize work with minimal supervision.
· Familiarity with medical terminology and ability to interpret medical reports.
· Excellent PC skills, to include experience using Microsoft Office and Outlook.
High School Diploma or GED required.
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health at mailto:EEO_AA@CVSHealth.com
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/