Top 165 Eligibility specialist Jobs in Montana

Senior Claim Benefit Specialist - Remote
CVS Health —Montana
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
Program Eligibility Specialist
Human Resource Development Council Dist IX, Inc. —Bozeman, MT
- $24 an hour
- Seasonal
- Spanish
- Google Workspace
- Computer literacy
3d
Brain Injury Program Specialist
State of Montana —Montana
- $34.09 an hour
- Full-time
- Public speaking
- Mid-level
- Bachelor's degree
- Paid holidays
- Health insurance
Certification Specialist
State of Montana —Helena, MT
- $29.01 an hour
- Online Application
- Writing skills
- Mid-level
- Office
- Paid holidays
- Health insurance
7d
Child Protection Specialist (Region 5 - Western)
State of Montana —Montana
- $31.55 an hour
- Weekends as needed
- Word processing
- Mid-level
- Experience working with children
- Paid holidays
- Health insurance
Data Governance Specialist
State of Montana —Helena, MT
- $36.19 an hour
- Online Application
- Computer Science
- Bachelor of Science
- Mid-level
- Paid holidays
- Health insurance
Occupational Health Safety Specialist
State of Montana —Montana
- $35.05 - $39.50 an hour
- Online Application
- Hybrid work
- Up to 50% travel
- Writing skills
- Continuous improvement
- Paid holidays
- Health insurance
11d
Training Support Specialist
State of Montana —Helena, MT
- $24 - $26 an hour
- Online Application
- Background check
- Classroom
- Customer service
- Paid holidays
- Health insurance
13d
Quality and Compliance Specialist
State of Montana —Boulder, MT
- $30.25 an hour
- Online Application
- Writing skills
- Research
- Mid-level
- Paid holidays
- Health insurance
4d
Instructional Specialist, Writing Lab
Flathead Valley Community College —Kalispell, MT
- $22 - $24 an hour
- Weekends as needed
- Classroom
- Customer service
- English
- 403(b) matching
- Dental insurance
Family Support Specialist
Benchmark Human Services —Valier, MT
- $40,000 - $44,000 a year
- Online Application
- Hybrid work
- Background check
- Nursing
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
13d
Family Support Specialist
Benchmark Human Services —Havre, MT
- $40,000 - $44,000 a year
- Online Application
- Hybrid work
- Background check
- Nursing
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
13d
Family Support Specialist Assistant
Benchmark Human Services —Harlem, MT
- $18 - $20 an hour
- Online Application
- Hybrid work
- Background check
- High school diploma or GED
- Driver's License
- Mileage reimbursement
- Health insurance
Quick Apply
13d
Family Support Specialist
Benchmark Human Services —Browning, MT
- $40,000 - $44,000 a year
- Online Application
- Hybrid work
- Background check
- Nursing
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
13d
Family Support Specialist
Benchmark Human Services —Harlem, MT
- $40,000 - $44,000 a year
- Online Application
- Hybrid work
- Background check
- Nursing
- Mid-level
- Mileage reimbursement
- Health insurance
Quick Apply
13d
Family Support Specialist Assistant
Benchmark Human Services —Kalispell, MT
- $18 - $20 an hour
- Online Application
- Background check
- High school diploma or GED
- Driver's License
- Mileage reimbursement
- Health insurance
Quick Apply
Family Support Specialist Assistant
Benchmark Human Services —Valier, MT
- $18 - $20 an hour
- Online Application
- Hybrid work
- Background check
- High school diploma or GED
- Driver's License
- Mileage reimbursement
- Health insurance
Quick Apply
13d
Training Specialist
State of Montana —Helena, MT
- $32.93 - $33.91 an hour
- Full-time
- Customer service
- Writing skills
- Mid-level
- Paid holidays
- Health insurance
10d
Energy Bill Assistance Eligibility Specialist
District XI Human Resource Council, Inc. —Missoula, MT
- $20.17 an hour
- Temporary
- In-person
- Entry level
- Paid holidays
- Health insurance
Quick Apply
14d
Customer Care Specialist
Big Sky Resort —Big Sky, MT
- Part-time
- Typing
- Communication skills
- Entry level
- Paid time off

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eligibility specialist jobs near montana

Senior Claim Benefit Specialist - Remote

CVS Health -
Montana

Apply Now

Job Details

Full-time
$18.50 - $42.35 an hour

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

High school diploma or GED
Health insurance knowledge

Full Job Description

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 Summary
Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience.

Additional Responsibilities

Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise.
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures.
Identifies and reports potential overpayments, underpayments, and other claim irregularities.
Performs claim rework calculations as needed.
Trains and mentors as needed to enhance team performance and technical proficiency.
Conducts outbound calls to obtain required information for claims or reconsideration requests.

Required Qualifications

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator.
Proven success working in a high‑volume, production‑driven environment.
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail.

Preferred Qualifications

Self-Funding experience
DG system knowledge

Education

High School Diploma required
Preferred Associates degree or equivalent work experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

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.

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

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

Apply Now

Refine Your Search

eligibility specialist jobs in montana

Senior Claim Benefit Specialist - Remote

Program Eligibility Specialist

Brain Injury Program Specialist

Certification Specialist

Child Protection Specialist (Region 5 - Western)

Data Governance Specialist

Occupational Health Safety Specialist

Training Support Specialist

Quality and Compliance Specialist

Instructional Specialist, Writing Lab

Family Support Specialist

Family Support Specialist

Family Support Specialist Assistant

Family Support Specialist

Family Support Specialist

Family Support Specialist Assistant

Family Support Specialist Assistant

Training Specialist

Energy Bill Assistance Eligibility Specialist

Customer Care Specialist

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