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CVS Health logo
CVS Health

CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca

Appeal Examiner

Location

United Kingdom

Posted

11 days ago

Salary

$17 - $31 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Appeal Examiner

CVS Health

Role Description The Appeal Examiner is responsible for managing, to resolution, appeal scenarios. These may contain responses from multiple business units. This person is responsible for ensuring timely, customer-focused responses. In this role, you will: - Review and analyze any relevant appeals as assigned. - Interpret any policy and coverage guidelines as dictated by organizational policy and supervisory discretion. - Coordinate reviews as needed. - Draft resolution letters in order to ensure a timely and accurate response. - Ensure timely handling of assigned cases, contingent on departmental workload and assignments. Qualifications - 1+ years customer service experience in a metrics-driven environment. - 1+ years administrative experience. - Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook). Requirements - 1+ years of experience with plan documents, appeals, compliance and/or claim research. - 1+ year of experience with interpreting health plans and benefits. - Strong familiarity with medical terminology, self-funding, and/or ERISA (Employee Retirement Income Security Act) requirements. Benefits - Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. - Medical, dental, and vision coverage. - Paid time off. - Retirement savings options. - Wellness programs and other resources, based on eligibility.

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