CVS Customer Service Representative: Remote $17.00 - $28.46 Hour

Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. -Customer inquiries are of basic and at times complex nature. Engages, consults and educates members based upon the member’s unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care. Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors.

Education

High School diploma, G.E.D. or equivalent experience

Anticipated Weekly Hours

40

Time Type

Full time

Claims Representative - Workers Compensation (REMOTE)

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.

• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

• Administers subrogation of claims and negotiates settlements.

• Communicates claim action with claimant and client.

• Ensures claim files are properly documented and claims coding is correct.

• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

• Maintains professional client relationships

Accounts Receivable associate $20-$22 hour 

D&S Community Services, a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. 

Your Role 

• Liaison with operations and other functions on accounts receivable and general ledger reconciliation issues 
• Review and maintain daily tracking of Room & Board activity.
• Analyze monthly accounts receivable balances and make recommendations for bad debt reserves; prepare data and analysis to support the valuation of accounts receivable and adequacy of reserves 
• Weekly review of Service Charge Errors and Duplicate Charge entries for validation and removal
• Review setup in billing system to ensure accuracy and analyze revenue reports 
• Facilitate monthly audits of accounts receivable and Room &Board
• Maintain an effective control environment for accounting operations
• Responsible for new and ongoing Avatar (our client information network and billing/AR system) setups/updates