Position Summary
Collaborate with a team specializing in Grievance and Appeals systems. Respond to incoming calls from members, family members, or providers who wish to file an appeal or grievance.

- Confirm member enrollment within one of Mercy Care Plan's various lines of business.
- Verify or gather accurate demographic information from the caller.
- Confirm any additional required information on members who receive special assistance, Children's Rehabilitative Services (CRS), or Department of Children's Services (DCS).
- Clearly explain each process available to the member or caller based on their specific line of business.
- Access designated systems to retrieve member denials when processing an appeal.

- Thoroughly document the member or caller's reason for contacting Grievance and Appeals.

- Special projects as needed

Required Qualifications
- 1+ years of knowledge with the seriously mentally ill Behavioral Health system in Maricopa County

- 1+ years of knowledge of Medicaid and Medicare programs

- 1+ years of healthcare customer service experience
- Strong written and verbal communication skills
- Proficient in Microsoft applications such as Word, Outlook, and Teams
- Ability to manage multiple tasks simultaneously
- Critical thinking skills are essential
- Commitment to maintaining HIPAA compliance at all times

Preferred Qualifications

- 1+ years of strong data entry skills

- 1+ years QNXT/PeopleSafe/CAS system knowledge/experience

- Dependability and a positive attitude

- Collaborative team member

Education

- High School Diploma or GED Required

Pay Range

The typical pay range for this role is:

$17.00 - $25.65

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: 10/31/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.