Complaint & Appeals Analyst (Must reside in Arizona)

CVS Health•Work At Home-Arizona, AZ

1d•$17 - $28•Remote

About The Position

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.

Requirements

Must reside in Arizona.
At least 6 months of experience with Medicare and Medicaid programs.
At least 6 months of experience with behavioral health systems related to individuals with serious mental illness.
Proficiency with typing and basic computer knowledge.
Ability to navigate multiple systems to retrieve data during calls.
Ability to critically assess the information provided by callers to ensure completeness and accuracy.
Call center/medical call center experience

Nice To Haves

Resides in Maricopa or Pinal Counties, Arizona.
Excellent communication skills.
Strong critical thinking skills.
Ability to multitask and stay organized.

Responsibilities

Verify caller enrollment status with Mercy Care Plan.
Collect and document accurate demographic information from members/callers, as well as from Mercy Care systems.
Confirm details such as whether members receive special assistance (applicable to members with serious mental illness).
Utilize the QuickBase database to complete intake forms, ensuring documentation of members' reasons for calling is thorough and precise.
Provide empathetic and compassionate support to all callers.
Assist with special projects as assigned.