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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.
Primary Job Duties & Responsibilities
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This position supports the daily processing of appeals in the Par Provider Dental Appeals.
Job functions include, completing appeals determination letters, prepping dental requests, updating systems, completing reporting as necessary, working collaboratively with clinical support staff (Medical Directors, Nurses, Providers, etc.), and movement of cases in the MedHok system.
All work is to be handled in compliance of turnaround times and regulatory standards.
Responsible for managing to resolution complaint/appeal scenarios for dental products, which may contain multiple issues and may require coordination of responses from multiple business units. Ensure timely, provider focused response to complaints/appeals.
Identify trends and emerging issues and report and recommend solutions.
Required Qualifications
Comprehends contemporary dental care standards, practices, and procedures.
Possesses high level of technical knowledge and radiograph interpretation skills.
If certified or licensed, maintains required continuing education requirements.
Preferred Qualifications
Uses available resources efficiently.
Is well organized, continually focusing upon maximal utilization of time and talent.
Embraces change and readily accepts additional responsibilities.
Researches issues thoroughly and reports findings clearly, providing options for resolution.
Education
Vocational school or college level training beyond high school
CDA. RDA, RDH with at least five years clinical experience
Pay Range
The typical pay range for this role is:
$21.10 - $44.99
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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 11/30/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.