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 The Senior Claims Benefit Specialist will review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims. They will adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. This person will also process provider refunds and returned checks. They also may handle customer service inquiries and problems. In this role, you will: - Perform adjustments across all dollar amount levels on customer service platforms, specifically by using technical and claims processing expertise. - Apply medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. - Perform claim re-work calculations. - Follow through with completion of claim overpayments, underpayments, and any other irregularities. - Process complex, non-routine Provider Refunds and Returned Checks. - Review and interpret medical contract language, using provider contracts to confirm whether a claim is overpaid, in order to allocate refund checks. - Handle telephonic and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. - Ensure all compliance requirements are satisfied and that all payments are made following company practices and procedures. - Review and handle relevant correspondences assigned to the team that may result in adjustment to claims. - May provide job shadowing to less experienced staff members. - Utilize all resource materials to manage job responsibilities. Required Qualifications - 2+ years of experience with medical claim processing. - 2+ years of experience in a production environment. Preferred Qualifications - Demonstrated ability to handle multiple assignments competently, accurately, and efficiently. - Effective communication, organizational, and interpersonal skills. - Previous experience with DG system claims processing. Education - Associate’s degree or equivalent experience (high school diploma or GED + 2 years of relevant experience). Anticipated Weekly Hours 40 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. 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 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: 04/16/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

• Technical Problem Solving: You will manage and resolve complex inbound technical tickets via email and live chat. While most interactions are written, you will lead occasional video calls to troubleshoot high-priority issues and provide an expert, effortless user experience. • Product Advocacy and Insights: You will serve as the essential bridge between customer friction and long-term product solutions. By identifying, reproducing, and documenting bugs for the Engineering team, you will ensure technical issues are resolved at the root. You will also act as a primary voice of the customer, gathering feedback from daily interactions to help shape and influence the product roadmap. • AI and Knowledge Engineering: You will write and maintain high-quality internal and external documentation, including FAQs and how-to guides. You will leverage AI tools to optimize these resources, ensuring our AI Agents can effectively ingest and utilize data to assist both internal teams and external users. • Workflow Automation: You will use a variety of AI tools in creative ways to automate, optimize, and expedite support workflows and internal processes. • Customer Configurations: You will act as the technical lead for complex account setups, including provisioning, data and integrations, and workflow tailoring.

• Respond promptly to customer inquiries via phone, email, and chat with technical expertise and professionalism. • Troubleshoot and resolve technical issues related to Lucidya’s platform. • Guide customers through product features, usage best practices, and configuration settings to maximize value. • Document and escalate complex technical problems to development or engineering teams for deeper investigation. • Maintain detailed records of customer interactions, issues, and resolutions in CRM systems. • Collaborate with product, engineering, and QA teams to communicate customer feedback and advocate for product improvements. • Contribute to the development and maintenance of support documentation, FAQs, and knowledge bases. • Stay up-to-date with product updates, features, and industry trends to provide accurate and helpful guidance.

Under the supervision of the Director, Enterprise Applications, the IT Applications Specialist III – HRIS provides support of business-critical human resource applications, software, and architecture in the development, UAT and productions environments, and manage project activities for InnovAge and its affiliates. Essential Functions and Work Responsibilities Functional Category: Application and business user support, process improvement work, lead role activities, documentation, policy/procedure compliance, some project management activities Estimated Percent of time Spent – 100% General Requirements for Application Support Position - Installs applications in the development and system test environments for Development and UAT testing. - Performs system administration by writing utilities and monitoring information technology services. - Provides technical support and maintenance of installed applications software. Tier II and Enterprise level - Assists with implementation, configuration and testing of new product versions with end users. - Interacts with end users and software vendors in order to troubleshoot installation and implementation issues. - Develops and maintains detailed technical knowledge of the specifications, operation, and diagnostic of products. - Organizes, produces, and reports on the progress of ongoing testing, trials, and evaluation of new products and services. - Conducts orientation to new users regarding applications of software. - Functions as a key point of user contact and customer service for business systems and is accountable for user satisfaction. - Assists in the execution of large and small IT projects. - Actively supports applications system and collaborates with Service Desk team to resolve problems and incidents. - Acts in a Lead role for the Application support team. Help team tactically execute day-to-day responsibilities and assists where needed. - Supports mobile devices. Travel Requirements Travel - Less than 5% Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. REQUIRED Education - Bachelor’s degree in Computer Science, Information Systems Management, Accounting/Finance, Engineering or a related field from an accredited college/university Work Experience and Qualifications - Minimum of 8 years of experience providing applications support, systems integration and system administration - Experience in supporting business related systems. - Experience with and understanding relational databases, Active Directory and Microsoft Office Suite. - Understanding of Human Resources principles depending on role. - Understanding of IT General Controls and how to operate within said controls - Experience with Tier II and Enterprise level systems - Ability to analyze situations/problems and determine a plan on how to address without a playbook using strong critical thinking skills - Strong understanding of business/operational transactions and process flow as it relates to various types of Business Systems and related transactions. - Install and configure application components. Tier II and Enterprise level systems. - Troubleshoot and resolve day to day user issues including suspended transactions, End user issues, system performance, etc. - Critical thinking skills are a requirement as this position will also fulfill lead related duties and assist the team with execution of responsibilities. - Current knowledge in light programming/scripting (Powershell, VB, TSQL, etc) - Experienced in identifying problems, gathering data, assembling requirements, and recommending solutions. - Skilled at prioritizing and being able to work under the pressure of multiple demands while meeting/exceeding deadlines - Experience with supporting databases, specifically SQL Server, SSRS, and SSIS. - Experience working in a team-oriented and collaborative environment. Other Knowledge Skills and Abilities Required - Organizational and conflict resolution skills - Exceptional Written and verbal communication skills - Strong critical/analytical thinking skills. - Strong business acumen and customer service attitude - Excellent managerial and supervisory skills - Ability to consistently deliver on deadlines, on time and within budget - Excellent analytical and problem-solving skills - Financial skills and ability to analyze financial data - High tolerance of ambiguity - Mindset of “value creation” (as opposed to task completion) InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model. InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. Applicants are considered until the position is filled. $86,800-$112,900 Compensation Disclaimer The pay may vary depending on job related factors, such as work location, experience, knowledge, skills, education, certifications, training and internal equity. InnovAge offers a comprehensive benefits package, which includes medical, dental, vision, 401(k) plan with company match, short and long-term disability, life insurance, supplemental life insurance, ADD, flexible spending account, paid time off and company paid holidays. Attention Florida Applicants This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse. For more information, please visit the Clearinghouse Education and Awareness website: https://info.flclearinghouse.com Agency Disclaimer InnovAge will not accept unsolicited resumes from search firms for this employment opportunity. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.