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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary 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 units. Ensure timely, customer focused response to complaints/appeals. Identify trends and emerging issues and report and recommend solutions. This position can be anywhere in the United States. Required Qualifications 1 year experience that includes both HMO and Traditional claim platforms. 1 Year experience working with Medicare, benefits, compliance and regulatory analysis, special investigations, provider relations, customer service or audit experience. Preferred Qualifications 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 or Equivalent Anticipated Weekly Hours 40 Time Type Full time Pay Range The Typical Pay Range For This Role Is $17.00 - $28.46 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great Benefits For Great People We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Seton Heritage Ministries is seeking a highly organized, mission-driven Executive Assistant to provide high-level support to our Executive Director, Senior Leadership, and Board of Directors. This pivotal role helps advance our mission by managing executive schedules, coordinating...
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