CVS Pharmacy Claims Processor Resume Examples
Updated 8 min read
This article will guide readers through the process of creating a resume specifically tailored to the position of Pharmacy Claims Processor at CVS. It will provide information on what skills and experience should be highlighted, as well as tips for writing an effective summary statement and crafting a compelling cover letter. Readers will also learn how to research the company and create a resume that stands out from other applicants.
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CVS Pharmacy Claims Processor Resume Example
Katlyn Berni, Pharmacy Claims Processor
katlyn.berni@gmail.com
(351) 483-2074
Richmond, VA
Professional Summary
I am an experienced Pharmacy Claims Processor with over 1 year of experience in the field. I have successfully analyzed, evaluated and processed claims for various prescription drugs. I am highly proficient in utilizing various computer software, including pharmacy management and medical billing systems. Additionally, I have extensive knowledge of the policies and regulations pertaining to the submission of pharmacy claims. I am also highly organized and detail-oriented, and I am capable of managing multiple tasks simultaneously. With my strong technical and communication skills, I am confident that I can be a valuable asset to any organization.
Work Experience
Senior Pharmacy Claims Processor at CVS Caremark, VA
Dec 2022 - Present
- Reduced CVS Caremark's claims processing time by 25% by streamlining the claims process. This resulted in an average of 6,500 claims processed per day.
- Developed a new system for tracking and reporting patient and provider data, leading to improved accuracy and faster claims processing.
- Automated the process of verifying and approving pharmacy claims, resulting in a 40% increase in the number of claims processed per hour.
- Implemented a new system for flagging suspicious claims, which resulted in a 90% reduction in fraudulent claims.
Pharmacy Claims Processor at Express Scripts, VA
Sep 2022 - Nov 2022
- Processed over 5,000 pharmacy claims per month, resulting in a 50% reduction in backlog and increased customer satisfaction.
- Developed an improved system for claims processing, reducing manual inputs by 85% and increasing accuracy of claims by 95%.
- Spearheaded the development of a new automated system to reduce processing time from days to hours, increasing employee efficiency by 50%.
- Led a team of 10 pharmacy claims processors to meet monthly goals, resulting in a 20% increase in claims processed.
Education
Associate of Applied Science in Pharmacy Technology at Tidewater Community College, VA
Aug 2017 - May 2022
Relevant Coursework: Medical Terminology, Pharmacology, Pharmacy Calculations, Drug Interactions, Pharmacy Law and Ethics, Sterile and Nonsterile Compounding, and Pharmacy Technology.
Skills
- Data Entry
- Insurance Verification
- Medical Terminology
- Claims Processing
- Attention to Detail
- Problem Solving
- Time Management
Certificates
- Certified Pharmacy Technician (CPT)
- Certified Professional Coder-Pharmacist (CPCP)
Tips for Writing a Better CVS Pharmacy Claims Processor Resume
1. Highlight Your Knowledge of CVS Pharmacy Processes: Demonstrate your familiarity with CVS Pharmacy processes, such as claims submission, review, and processing. Showcase your knowledge of industry-specific software used to manage claims and other related tasks.
2. Demonstrate Your Ability to Adapt Quickly: The ability to quickly adapt to changes in the pharmacy environment is a must for any claims processor. Showcase how you have successfully adapted in the past by providing examples of how you stayed up-to-date with new requirements or processes.
3. Detail Your Problem Solving Skills: As a claims processor, problem solving skills are essential in resolving customer inquiries and resolving discrepancies between submitted documents and records. Provide specific examples of how you have successfully tackled difficult problems on the job in the past.
4. Focus on Your Communication Skills: Claims processors must be able to communicate effectively with customers, fellow employees, and management alike. Highlight any relevant experience that demonstrates your excellent communication skills, such as responding to customer inquiries or working with other departments to resolve issues quickly and efficiently.
5. Include Relevant Education & Certifications: Make sure to include any education or certifications that are related to the position such as a degree in pharmacy or medical billing/coding certification. This will help demonstrate your commitment to staying current with industry standards and regulations which are important for this role.
Related: Claims Processor Resume Examples
Key Skills Hiring Managers Look for on CVS Pharmacy Claims Processor Resumes
When applying for a Pharmacy Claims Processor opportunity at CVS, it is important to incorporate keywords from the job description into your resume and cover letter. This is because CVS utilizes Applicant Tracking Systems (ATS) to scan resumes and cover letters for relevant keywords. ATS systems are designed to filter out resumes that do not contain the necessary keywords, so if you want your application to be seen, it is important that you include all relevant keywords from the job description. Doing this will ensure that your application stands out and has a higher chance of being selected for further review.
When applying for pharmacy claims processor positions at CVS, you may come across the following common skills and key terms:
| Key Skills and Proficiencies | |
|---|---|
| Claims processing | Medical coding |
| Data entry | Insurance verification |
| Billing and reimbursement | Regulatory compliance |
| Customer service | Problem solving |
| Documentation | Computer proficiency |
| Attention to detail | Time management |
| Communication skills | Analytical thinking |
| HIPAA regulations | ICD-10 coding |
| Auditing procedures | Interpersonal skills |
| Multi-tasking | Medicare/Medicaid rules and regulations |
| Knowledge of medical terminology | Quality assurance |
Related: Claims Processor Skills: Definition and Examples
Common Action Verbs for CVS Pharmacy Claims Processor Resumes
Finding action verbs to use on a resume can be tricky. It is important to use varied verbs when constructing a resume, as this adds variety and helps the reader better understand your skills and experience. For example, if you are applying for a position as a CVS Pharmacy Claims Processor, some applicable action verbs could include “processed”, “verified”, “audited”, “reviewed” or “resolved”. By using these different words throughout your resume, you will create a more dynamic document that showcases your qualifications in an effective way.
To give you a competitive edge, we've compiled a list of powerful action verbs that can help strengthen your resume and increase your chances of landing your next interview:
| Action Verbs | |
|---|---|
| Processed | Verified |
| Submitted | Audited |
| Resolved | Reconciled |
| Investigated | Analyzed |
| Monitored | Managed |
| Updated | Reviewed |
| Assessed | Interpreted |
| Entered | Coordinated |
| Generated | Maintained |
| Compiled | Calculated |
| Documented | Validated |
Related: What does a Claims Processor do?