Health Benefits Appeals Specialist

CVS Health; Virginia Beach (VA); Sur place; USD 23 000 - 43 000; Plein temps

Avantages offerts par ce poste

Medical coverage

Dental coverage

Vision coverage

Résumé du poste

CVS Health in Virginia Beach is seeking a detail‑oriented reviewer to manage intake, investigation, and resolution of appeals, complaints, and grievances across products. You will coordinate among business units to ensure accurate, timely responses and identify trends for process improvements.

The role requires 1–2 years in claims, benefits, or regulatory analysis, strong analytical skills, and proficiency with Excel and Word. This is a full‑time position based on site in Virginia Beach.

Qualifications

• Experience in reading or researching benefit language.
• 1-2 years experience that includes but is not limited to claim platforms, products, and benefits; patient management; product or contract drafting; compliance and regulatory analysis; special investigations; provider relations; customer service or audit experience.

Responsabilités

• Responsible for intake, investigation and resolution of appeals, complaints and grievances for all products, coordinating responses from multiple business units.
• Identify trends and emerging issues and report and recommend solutions.
• Coordinate final communication to member/provider for final resolution and closure.
• Serve as a technical resource to colleagues regarding appeals, complaints and grievance issues.

Connaissances

Analytical thinking

Attention to detail

Verbal and written communication

Excel

Microsoft Word

Regulatory analysis

Formation

High School diploma or GED

Some college education

Outils

Excel

Microsoft Word

Claim platforms experience

Description du poste

CVS Health in Virginia Beach is seeking a detail‑oriented reviewer to manage intake, investigation, and resolution of appeals, complaints, and grievances across products. You will coordinate among business units to ensure accurate, timely responses and identify trends for process improvements.

The role requires 1–2 years in claims, benefits, or regulatory analysis, strong analytical skills, and proficiency with Excel and Word. This is a full‑time position based on site in Virginia Beach.