Appeal Examiner- Meritain Health

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: The Appeal Examiner is responsible for managing, to resolution, appeal scenarios. These may contain responses from multiple business units. This person is responsible for ensuring timely, customer focused responses. In this role, you will: Review and analyze any relevant appeals as assigned. Interpret any policy and coverage guidelines as dictated by organizational policy and supervisory discretion. Coordinate reviews as needed. Draft resolution letters in order to ensure a timely and accurate response. Ensure timely handling of assigned cases, contingent on departmental workload and assignments. Required Qualifications: 1+ years customer service experience in a metrics driven environment. 1+ years administrative experience. Work...