CVS Health Jobs Remote for Beginners Apply Now 2021

By | April 13, 2022

Job Responsibilities : Complaint Appeals Consultant

Salary : $17 per hour

Company : CVS Health

Location : Remote US

Educational requirements : High School

  • Processes appeals and ensures timely and accurate completion. Maintains a caseload and monitors day to day compliance of appeal decision time frames.

    Requests and reviews clinical and medical records for completeness. Assigns reviews to Medical Directors and enters all data related to appeals and case reviews into a database. Participates in data and analysis of reports regarding appeal activity as well as preparing for appeals audits. Consults with manager on problem cases and interfaces with case managers, clinical supervisors, and other personnel in resolving appeal questions.
    Responds to member, provider, and client telephone inquiries regarding status, process and outcome of appeals. Organizes volume of work and work-flow so that performance standards and proper procedures for appeals resolution according to client requirements and state and federal regulations are addressed.

    Required Qualifications

  • Experience in customer interactions and review of health related materials.
  • Strong interpersonal skills and attention to detail.
  • Ability to organize work and seek help on tasks where needed.
  • Strong reading and writing skills ensuring documents meet standards and are accurate.
  • Located in Arizona.
  • Good knowledge of AHCCCS and healthcare industry.

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