Appeals Nurse Associate

Industry: Private

Employment Type:- Full Time

Work Hours:-  8 Hours

Locations:- USA

Full Job Description:-

Are you an experienced and compassionate Appeals Nurse Associate looking for a fulfilling role at CVS Health? We’re looking for a motivated individual who is passionate about providing exceptional patient care to join our team. In this role, you will be responsible for providing support and guidance to CVS Health clients as they navigate the appeals process.The ideal candidate for this position should have experience in the healthcare industry, as well as a strong knowledge of the appeals process. We’re looking for someone who is organized, detail-oriented, and able to resolve complex issues in a timely manner. Additionally, we’re seeking a candidate who is passionate about providing the best possible care to our clients and is committed to delivering outstanding customer service. If this sounds like you, then we’d love to hear from you!

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Responsibilities:

  • Provide support and guidance to CVS Health clients as they navigate the appeals process.
  • Resolve complex issues in a timely manner.
  • Demonstrate a strong knowledge of the appeals process and healthcare industry.
  • Maintain a high level of organization and attention to detail.
  • Deliver outstanding customer service.
  • Ensure compliance with all applicable laws and regulations.
  • Investigate and document any potential issues or concerns.
  • Analyze data and reports to identify trends.
  • Monitor and track appeal cases.
  • Communicate with internal and external stakeholders.

Job Qualifications

  • Knowledge Of Medical Terminology
  • Excellent Customer Service And Communication Skills
  • Familiarity With Cvs Health Policies And Procedures
  • Ability To Work Independently With Minimal Supervision
  • Strong Organizational And Problem Solving Skills
  • Experience With Insurance Claims And Appeals Processes
  • Knowledge Of State And Federal Regulations Regarding Appeals
  • Understanding Of Basic Medical Coding

Required Skills

  • Documentation
  • Communication
  • Negotiation
  • Leadership
  • Listening
  • Empathy
  • Organization
  • Analytical
  • Patience
  • Problem-Solving
  • Adaptability
  • Decision-Making
  • Mediation
  • Interpersonal
  • Time-Management

Soft Skills

  • Communication
  • Leadership
  • Negotiation
  • Problem Solving
  • Time management
  • Interpersonal Skills
  • self-motivation
  • Critical thinking
  • Teamwork
  • Adaptability

Appeals Nurse Associate

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