Senior Coordinator - Complaint Appeals Operations

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Responsible for managing appeal scenarios and coordinating responses. • Develop into a subject matter expert by providing training and coaching. • Researches and resolves incoming electronic appeals. • Identifies trends and emerging issues and reports on solutions. • Serves as point person for newer staff in answering questions.

Requirements

• 1-2 years Medicare part C Appeals experience. • Experience in reading or researching benefit language in SPDs or COCs. • Experience in research and analysis of claim processing a plus. • Excellent verbal and written communication skills. • Excellent customer service skills. • Experience documenting workflows and reengineering efforts.

Benefits

• A full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • Fully-paid term life insurance for eligible employees. • Short-term and long-term disability benefits. • Well-being programs. • Education assistance. • Free development courses. • CVS store discount. • Paid Time Off (PTO) and vacation pay. • Paid holidays throughout the calendar year.