Dental Healthcare Analyst

CVS Health

3d • $21 - $45

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. Primary Job Duties & Responsibilities This position supports the daily processing of appeals in the Par Provider Dental Appeals department. 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.

Requirements

• 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.
• Vocational school or college level training beyond high school CDA. RDA, RDH with at least five years clinical experience

Nice To Haves

• 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.

Responsibilities

• completing appeals determination letters
• prepping dental requests
• updating systems
• completing reporting as necessary
• working collaboratively with clinical support staff (Medical Directors, Nurses, Providers, etc.)
• movement of cases in the MedHok system
• managing to resolution complaint/appeal scenarios for dental products
• 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.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed