Quality Specialist

Position Summary

Claim 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.

Required Qualifications

• 1-2 years of auditing and/or claims processing experience
• 1-2 years of Microsoft Office experience
• Knowledge of CPT codes
• Knowledge of ICD-10 codes
• Strong attention to details

Preferred Qualifications

• 1-2 years of DG experience
• 2-3 years of claims processing/auditing experience
• Exceptional attention to detail
• Ability to quickly become a subject matter expert in new areas
• Proven track record of managing workload efficiently in a high-volume environment
• Self Funded claim knowledge a plus

Education

• High school diploma or GED

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.

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 people

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.

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We anticipate the application window for this opening will close on: 03/20/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.