Senior Coordinator, Complaint & Appeals
CVS Health•Work At Home-Ohio, NV
•$19 - $35•Remote
About The Position
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.
Requirements
- 2–5 years of relevant experience (healthcare, insurance, or compliance preferred)
- Strong analytical thinking and problem-solving skills
- Attention to detail with the ability to interpret policies and regulations
- Excellent communication and decision-making abilities
- High school diploma or equivalent
Responsibilities
- Review and manage patient complaints, appeals, and grievances, escalating complex cases as needed
- Conduct in-depth case analysis to identify errors, inconsistencies, or compliance gaps
- Coordinate and draft appeal decision letters, ensuring timely and accurate resolution
- Perform audits and monitor compliance with federal and state regulations
- Analyze KPIs to improve team performance and operational efficiency
- Support patient billing inquiries with accurate, responsive service
- Train, mentor, and guide team members on best practices and processes
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
