Appeals & Grievance Specialist

CVS Health; Baton Rouge (LA); Presencial; USD 23 000 - 35 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement savings

Wellness programs

Resumo da oferta

CVS Health in Baton Rouge, LA is seeking a detail‑minded Appeals Specialist to handle intake, investigation and resolution of appeals, complaints and grievances for all products. You will coordinate responses across business units, identify trends and ensure timely, customer‑centered communications.

Ideal candidates bring 1–2 years in claims platforms or benefits, strong knowledge of benefit language, and proficiency with Excel and Word.

Qualificações

• Experience reading or researching benefit language.
• 1-2 years experience in claims platforms, products, and benefits; patient management; contract drafting; compliance and regulatory analysis; special investigations; provider relations; customer service or audit experience.
• Experience in research and analysis of claim processing a plus.
• Some college preferred.
• High School or GED equivalent.

Responsabilidades

• Intake, investigation and resolution of appeals, complaints and grievances.
• Coordinate responses from multiple business units for final resolution.
• Identify trends and report potential solutions.
• Serve as a technical resource on appeals and related issues.

Conhecimentos

Benefit language

Claims processing

Customer service

Regulatory knowledge

Formação académica

Some college

High school or GED

Ferramentas

Excel

Microsoft Word

Descrição da oferta de emprego

CVS Health in Baton Rouge, LA is seeking a detail‑minded Appeals Specialist to handle intake, investigation and resolution of appeals, complaints and grievances for all products. You will coordinate responses across business units, identify trends and ensure timely, customer‑centered communications.

Ideal candidates bring 1–2 years in claims platforms or benefits, strong knowledge of benefit language, and proficiency with Excel and Word.