Senior Coordinator, Complaint and Appeals (Remote)
CVS Health
•Remote
About The Position
CVS Aetna is seeking a dedicated Senior Coordinator, Complaint and Appeals to join our remote team. In this role, you’ll play a critical role that supports the daily operations of the Commercial Member Clinical Appeals (CMCA) team.
Requirements
- 1–2 years of experience in an administrative type role.
- Strong written and verbal communication skills.
- Ability to manage multiple tasks efficiently.
- Proficiency in Microsoft Office Suite and basic computer skills.
Nice To Haves
- 1–2 years of experience in healthcare appeals, grievances, or a related administrative role.
- 1+ year working in a healthcare setting (e.g., insurance, hospital administration, or clinical support)
- Experience with the appeals process or related work.
Responsibilities
- Processing appeal determination letters, managing intake and expedited requests, updating internal systems, and generating reports.
- Supporting panel hearings and collaborating with clinical staff (Medical Directors, Nurses, Providers, etc.).
- Triaging incoming faxes and managing case movement within the Complaints and Appeals Tracking System (CATS).
- Completing tasks in accordance with regulatory standards and required turnaround times.
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
