Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business unitsEnsure timely, customer focused response to complaints/appealsIdentify trends and emerging issues and report and recommend solutions.
This position can be anywhere in the united states.
Required qualifications
Professional job experience
Covid requirements
Covid-19 vaccination requirement
Cvs health requires its colleagues in certain positions to be fully vaccinated against covid-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least one covid-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employmentFor the two covid-19 shot regimen, you will be required to provide proof of your second covid-19 shot within the first 60 days of your employmentFailure to provide timely proof of your covid-19 vaccination status will result in the termination of your employment with cvs health.
If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with cvs healthAs a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinatedIf your request for an accommodation is not approved, then your employment may be terminated.
Preferred qualifications
Medicare experience
Claims experience
Experience in reading or researching benefit language in summary plan description (spds) or certificate of coverage (cocs)
Experience in research and analysis of claim processing a plus
Education
High school/ged
Business overview
At aetna, a cvs health company, we are joined in a common purpose: helping people on their path to better healthWe are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focusedWorking together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplaceCvs health is an equal opportunity and affirmative action employerWe do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran statusWe proudly support and encourage people with military experience (active, veterans, reservists and national guard) as well as military spouses to apply for cvs health job opportunities.
