Position SummaryThe Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator, working with training staff, and team members as more complex cases and strategies are developed.
What you will do- Learn to navigate the systems, and create networking, for this role
- Develop filing, naming conventions, and documentation processes
- Conduct checklist workups and manage outbound communications via phone, fax, and email to facilitate negotiations.
- Work up and organize daily cases
- Make outbound calls, develop provider contacts, and understand production metrics
Required Qualifications- 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of benchmarking costs for medical services, supplies, and drugs.
- Previous medical provider/business office phone call handling history.
- Strengths in mathematical, written, and verbal skills.
Preferred Qualifications- Coding experience, CMS, and/or CPC Certification.
- Proficient in Usual and Customary (calculations) and cost-benchmarking for drugs, supplies, and services.
Education- Associates/High School graduate, or equivalent professional work experience.
Anticipated Weekly Hours40
Time TypeFull time
Pay RangeThe typical pay range for this role is:
$46,988.00 - $122,400.00
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.
Great benefits for great peopleWe 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.
We anticipate the application window for this opening will close on: 06/19/2026
