Reporting Appeal Analyst

CVS Health • Work At Home-Florida, ID

4d

About The Position

Responsible for analyzing complex data, reporting trends and provide recommendations for process improvement. Will also investigate, resolve, and report on insurance claim disputes, provider grievances, and coverage appeals to ensure compliance with regulatory standards.

Requirements

• 1-2 years reporting and analyzing data
• 2-3 plus years knowledge of plan documents, claims research, letter writing
• 2-3 plus years working with appeals, claims, or compliance
• 2-3 plus years experience working with documenting and interpreting Health Insurance plans
• Understand Excel and Word
• Able to interpret benefits
• Healthcare experience

Nice To Haves

• 3 plus years of prior claim or health insurance experience
• Familiarity with medical terminology
• Familiarity with self funding or ERISA requirements

Responsibilities

• Analyzing complex data
• Reporting trends
• Provide recommendations for process improvement
• Investigate, resolve, and report on insurance claim disputes, provider grievances, and coverage appeals to ensure compliance with regulatory standards.

Benefits

• medical coverage
• dental coverage
• vision coverage
• paid time off
• retirement savings options
• wellness programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED