Coordinator, Complaint and Appeals, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 28.46 USD / Hour

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Job Description:

Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues and may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/appeals. Identify trends and emerging issues and report and recommend solutions.

Job Responsibility:

Managing to resolution complaint/appeal scenarios for all products
Coordinating responses from multiple business units
Ensuring timely, customer focused response to complaints/appeals
Identifying trends and emerging issues
Reporting and recommending solutions

Requirements:

1 year experience that includes both HMO and Traditional claim platforms, products, and benefits
Patient management experience
Product, compliance and regulatory analysis experience
Special investigations experience
Provider relations experience
Customer service experience
Audit experience
High School or Equivalent education

Nice to have:

Medicare experience
Claims experience
Experience in reading or researching benefit language in Summary Plan Description (SPDs) or Certificate of Coverage (COCs)
Experience in research and analysis of claim processing

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation programs
Weight management programs
Confidential counseling
Financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
September 11, 2025

Expiration:
September 12, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Coordinator, Complaint and Appeals