Dispute Repricing Specialist; Meritain Health

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

The Dispute Repricing Specialist will be responsible for the accurate analysis and resolution of provider participation and pricing disputes. This will require knowledge of healthcare processes and internal operation requirements, policies, and procedures.

• Review provider dispute resolutions according to organizational guidelines.
• Research and respond to provider participation and pricing inquiries, specifically related to network contracts and agreements.
• Research identified issues; submit claim adjustment requests and determine the root cause of disputes.
• Serve as subject matter expertise in evaluating and responding to provider participation and pricing inquiries.
• Analyze post-paid healthcare claims as it relates to pricing needs.
• Apply in-depth research to determine accuracy of PPO(s) (Preferred Provider Organizations) use and pricing discounts applied.
• Communicate externally and with internal departments as it relates to various cases under review.
• Coordinate with other departments as necessary to facilitate resolution of claim related participation and pricing issues.
• Reading and interpreting appeals, standard reference materials, etc.
• Perform other duties as assigned.

• 2+ years of experience in healthcare, specifically with medical terminology, claim forms, and physician billing coding.
• 1+ years of experience with provider disputes.
• Demonstrated technical proficiency with Microsoft Office applications (Outlook, Excel, Teams, etc.).

• Strong basic math, communication, analytical, critical-thinking, and problem-solving skills.
• Previous experience with claims processing.
• Previous experience with customer service.
• Previous experience utilizing DG system.
• Previous experience in data entry.

• High school diploma or GED.

40

Full time

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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

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
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• 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

We anticipate the application window for this opening will close on: 01/21/2026

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