Complaint Appeals – OPS – CVS Health
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CVS Health (501+ Employees, 13% 2 Yr Employee Growth Rate)
6% 1-Year Employee Growth Rate | 13% 2-Year Employee Growth Rate | LinkedIn | $0 Venture Funding
What Is Employee Growth Rate & Why Is It Important?
Job Description
This is a permanent work at home opportunity for candidates located in any state.
The Medicare CTM Analyst will fully research and resolve beneficiary complaints submitted to the Centers for Medicaid and Medicare Services (CMS). These complaints can include various issues and may require coordination with various departments in order to fully reach resolution. Responses must be timely and include member focused solutions in both written and oral format.
Required Qualifications
Required Qualifications:
• Customer Service skills
• Experience handling customer service phone calls and elevated issues
• Ability to document resolution in written communication to members in a professional and easy to understand manner
• Experience troubleshooting complex customer problems
• Attention to detail
• Ability to work across various departments as necessary to establish the root cause and resolution of the issue
• Ability to toggle between multiple applications
• Ability to juggle caseload effectively
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
Preferred Qualifications
• General Medicare knowledge
• Prior experience with CTMs and/or Center for Medicaid and Medicare Services (CMS)
• Claim processing knowledge
• Ability to work flexible hours, some weekends and holidays. Overtime may be required during busy times of year.
Education
Education
• The highest level of education desired for candidates is a bachelor’s degree or equivalent work experience
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.