<p>We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.Position SummaryClaim Audit Quality Analyst is responsible for ensuring the accuracy and quality of claim audits across multiple areas within Meritain. This role demands a deep understanding of claims, plan documents, eligibility, coverages, and the unique requirements of various groups. The analyst will become a subject matter expert, applying detailed review skills and maintaining high standards in a fast-paced, high-production environment.Job description:Conduct thorough audits of claims, ensuring compliance with plan documents and eligibility requirements.Analyze and interpret a variety of group-specific guidelines and coverage "quirks".Maintain high accuracy and quality standards while meeting production goals.Manage time effectively to balance multiple priorities in a deadline-driven setting.Collaborate with team members to share knowledge and resolve complex audit issues.Document audit findings clearly and provide actionable feedback.Required Qualifications:1-3 years of claims processing1+ year(s) Knowledge of CPT codes1+ year(s) Knowledge of ICD-10 codesMicrosoft office experience.Preferred Qualifications:1-2 years of DG experienceStrong knowledge of claims processingExceptional attention to detailAbility to quickly become a subject matter expert in new areasProven track record of managing workload efficiently in a high-volume environmentEducation:High School diplomaAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $31.30This 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. 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 peopleWe 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/benefitsWe anticipate the application window for this opening will close on: 03/27/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p>