Dental Healthcare Analyst - Work From Home
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What you'll do
- 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.
What they're looking for
- 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 have
- Uses available resources efficiently.
- Is well organized, continually focusing upon maximal utilization of time and talent.
- Embraces change and readily accepts additional responsibilities.
- Research issues thoroughly and reports findings clearly, providing options for resolution.
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
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.
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.
Required Qualifications
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.
Preferred Qualifications
Uses available resources efficiently.
Is well organized, continually focusing upon maximal utilization of time and talent.
Embraces change and readily accepts additional responsibilities.
Research issues thoroughly and reports findings clearly, providing options for resolution.
Education
Vocational school or college level training beyond high school
CDA. RDA, RDH with at least five years clinical experience
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$21.10 - $44.99This 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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Company
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