by Terrance Ellis | Sep 17, 2025 | Uncategorized
Support members and providers by managing complex appeals and complaints, ensuring timely, accurate, and customer-focused resolutions—all from the comfort of your home.
About CVS Health
CVS Health is the nation’s leading health solutions company, connecting millions of Americans with affordable, convenient, and compassionate care. With more than 300,000 colleagues nationwide, we are building a healthier future together.
Schedule
- Full-time, 40 hours per week
- Remote, but must reside in Pennsylvania
- Standard business hours with occasional flexibility to meet program deadlines
Responsibilities
- Manage appeals and complaint cases as a single point of contact, researching and resolving complex issues.
- Review plan design, certifications of coverage, and contractual agreements to ensure appropriate benefit determinations.
- Investigate claims, payments, and member eligibility data before initiating the appeal process.
- Educate team members and act as a subject matter expert on workflows, appeals processes, and fiduciary responsibilities.
- Coordinate efforts across multiple departments to resolve claims, benefit interpretation, and regulatory requirements.
- Respond to escalated appeals, including those from regulators, executive offices, or state/federal agencies.
- Identify trends and provide input on solutions to improve processes.
- Deliver quality reviews, prepare documentation for audits, and support customer and regulatory meetings.
Requirements
- High School Diploma required
- At least 1 year of experience reading or researching benefit language in SPDs or Certificates of Coverage
- Strong problem-solving and organizational skills
- Excellent verbal and written communication skills
- Ability to manage multiple assignments accurately and efficiently
- Proven leadership qualities and ability to document and reengineer workflows
Preferred Qualifications
- 1 year of experience in claims research and analysis
- 1–2 years of Medicare Part C appeals experience
- Project management experience a plus
- Strong knowledge of specialty case types
Benefits
- Competitive pay: $18.50 – $35.29 per hour
- Affordable medical, dental, and vision coverage
- 401(k) with company match + employee stock purchase plan
- Paid time off and flexible scheduling options
- Family leave, dependent care resources, and tuition assistance
- Wellness screenings, confidential counseling, and financial coaching
- Comprehensive growth and career development opportunities
Join CVS Health and play a critical role in resolving appeals and protecting member rights while ensuring compassionate care delivery.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Sep 17, 2025 | Uncategorized
Help improve healthcare by supporting members through the appeals, complaints, and grievance process. This role is perfect for detail-oriented professionals who thrive in fast-paced environments and want to make a direct impact on patient care.
About CVS Health
CVS Health is the nation’s leading health solutions company, connecting millions of Americans with affordable, convenient, and compassionate care. With over 300,000 colleagues, we’re building a healthier world—one member at a time.
Schedule
- Full-time, 40 hours per week
- Remote, but must reside in Kentucky
- Standard business hours with potential for deadlines requiring quick turnarounds
What You’ll Do
- Intake, investigate, and resolve member/provider appeals, complaints, and grievances
- Research claims, eligibility, and benefit coverage to validate accuracy
- Coordinate responses across multiple business units to ensure timely resolution
- Draft and deliver final communications to members and providers
- Identify trends and recommend process improvements
- Serve as a subject matter resource to colleagues on appeals and grievance policies
What You Need
- High School Diploma or GED required (some college preferred)
- 1–2 years of experience in claims platforms, patient management, compliance, provider relations, or customer service
- Ability to research and interpret benefit language
- Strong analytical skills with attention to detail
- Excellent communication skills (written and verbal)
- Computer proficiency, including Excel and Word
- Ability to handle high-volume, deadline-driven work
Preferred Qualifications
- Experience with claims research and analysis
- Knowledge of clinical terminology, regulatory, and accreditation requirements
Benefits
- Competitive hourly pay: $17.00 – $25.65
- Affordable medical, dental, and vision plans
- 401(k) with company match + employee stock purchase plan
- Paid time off, flexible work schedules, and family leave
- Tuition assistance and career development programs
- Free wellness programs, including screenings and counseling
Take the next step in your healthcare career by joining a team committed to fairness, compassion, and meaningful results.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Sep 17, 2025 | Uncategorized
CVS Health is reimagining healthcare delivery—making it more connected, convenient, and compassionate. Join our team of 300,000+ purpose-driven colleagues who are committed to helping people live healthier lives.
About the Role
Coram, a CVS Health company, is hiring a Benefits Verification Representative. In this role, you’ll partner with Patient Intake Coordinators and insurance providers to verify coverage for in-home enteral therapy patients. You’ll be a vital link between patients, healthcare providers, and insurers—ensuring accurate, timely benefit verification and prior authorization so patients receive the care they need.
This is a remote position with opportunities for growth.
What You’ll Do
- Verify insurance coverage and complete benefit verification reviews.
- Obtain prior authorization information for new and existing patients.
- Coordinate closely with Patient Intake Coordinators.
- Communicate with insurance companies and healthcare providers.
- Enter and maintain accurate records in ACIS.
- Provide information about enteral home infusion services.
- Assist less experienced teammates with processes and reviews.
- Adhere to compliance regulations, policies, and best practices.
Required Qualifications
- 1+ year of customer service or call center experience.
- Strong data entry skills.
- Basic knowledge of Microsoft Office (Outlook, Word).
- High School Diploma or GED.
Preferred Qualifications
- Experience in healthcare, home infusion, or durable medical equipment (DME).
- Background in verifying insurance benefits.
- Familiarity with government and patient assistance programs.
Compensation & Schedule
- Full-time | 40 hours per week
- Pay range: $17.00 – $31.30 per hour (based on experience, skills, and location).
- Eligible for CVS Health bonus, commission, or short-term incentive programs.
Benefits
CVS Health offers a comprehensive package designed to support you and your family, including:
- Medical, dental, and vision coverage starting the first month after hire.
- 401(k) with company match + employee stock purchase plan.
- Paid time off, flexible schedules, and family leave options.
- Tuition assistance and career development programs.
- Free wellness programs, including screenings and counseling.
- Retail discounts at CVS stores nationwide.
Why Join CVS Health?
At CVS Health, you’ll be part of a team that values diversity, compassion, and innovation. We’re committed to fostering an inclusive workplace where everyone feels valued and has room to grow.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Sep 17, 2025 | Uncategorized
CVS Health is hiring Medical Billers to join our growing remote team. In this role, you’ll ensure accurate and timely billing of claims to insurance companies, playing a critical part in helping patients receive cost-effective care.
About CVS Health
As the nation’s leading health solutions company, CVS Health serves millions of Americans every day through our local presence, digital platforms, and more than 300,000 colleagues. We’re building a connected, compassionate world of health—and we’d love for you to be part of it.
Schedule & Compensation
- Full-time, 40 hours per week
- Flexible start times between 6:00 AM and 9:30 AM (end by 6:00 PM)
- Some locations require a 7:00 AM start time
- Pay range: $17.00 – $31.30 per hour (plus potential bonuses or short-term incentives depending on eligibility)
What You’ll Do
- Accurately bill claims to insurance companies for healthcare reimbursement
- Verify pricing, apply appropriate hold statuses, and resolve payer-rejected claims
- Prepare adjustments or write-offs as necessary
- Maintain compliance with quality and productivity standards
- Use Excel, Outlook, and Word to manage billing tasks and documentation
- Partner with customer service teams to ensure claims issues are resolved promptly
What You Need
- High School Diploma or GED (required)
- 1+ years of experience in a professional environment
- Beginner-level skills in Excel, Outlook, and Word
Preferred Qualifications
- Knowledge of healthcare billing and terminology
- Familiarity with collections practices or infusion services
- Accuracy in data entry
Benefits
- Medical, dental, and vision coverage (starting the first of the month after hire)
- 401(k) plan with company match and employee stock purchase program
- Paid time off, flexible work schedules, and family leave options
- Tuition assistance and career development opportunities
- Wellness programs, including confidential counseling and financial coaching
- Retail discounts at CVS locations nationwide
Application deadline: September 18, 2025
Be part of a team that’s transforming healthcare for millions of people across the U.S. Apply today to join CVS Health as a Medical Biller.
Happy Hunting,
~Two Chicks…
by Terrance Ellis | Sep 17, 2025 | Uncategorized
Help simplify medical record access and support compliance as a Release of Information Specialist I with Verisma. This role is perfect for detail-oriented professionals with healthcare or clerical experience who want to make a difference in patient information management.
About Verisma
Verisma is a trusted leader in release of information (ROI) services, combining secure technology and expert teams to streamline medical record processing. We partner with healthcare providers, law firms, insurers, and patients to ensure compliant, accurate, and efficient ROI services.
Schedule & Compensation
- Remote, full-time (some roles may be based at client sites)
- Hourly pay: $15.25 – $16.50
- Standard weekday business hours
What You’ll Do
- Process medical ROI requests quickly and accurately using Verisma software
- Support HIPAA-related release issue resolution
- Organize and review medical records, forms, and authorizations
- Provide customer service via phone, email, or in-person depending on assignment
- Maintain compliance with HIPAA, HITECH, and state/federal regulations
- Attend training sessions and stay current on reference materials
- Promote Verisma’s Core Values and team culture
What You Need
- High school diploma or equivalent (some college preferred)
- 2+ years of experience with medical records or clerical/office work
- Experience in a healthcare setting preferred
- Familiarity with HIPAA and state PHI regulations, preferred
- Strong computer skills (Microsoft Office, scanning, general office equipment)
- Detail-oriented and able to work independently
- Strong organizational, problem-solving, and customer service skills
Benefits
- Competitive hourly pay ($15.25–$16.50)
- Remote work opportunities with company-issued tools/software
- Training and career growth in the healthcare compliance space
- Opportunity to make a direct impact in protecting and managing patient information
Join Verisma and be part of a team dedicated to secure, compliant, and efficient medical record access.
Happy Hunting,
~Two Chicks…
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