Senior Appeals Examiner, CVS Health

Senior Appeals Examiner

CVS Health

Location:
United States

Category:
Customer Service

Contract Type:
Not provided

Salary:

18.50 - 42.35 USD / Hour

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Job Description:

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Job Responsibility:

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

Requirements:

1 plus years working with appeals, claims, and/or compliance
1 plus years experience working with documenting and interpreting Health Insurance plans
1 plus years knowledge of plan documents, claims research, letter writing
Understand Microsoft Excel and Word
Able to interpret benefits
Healthcare experience

Nice to have:

2 plus years of prior claim or health insurance experience
Familiarity with medical terminology, self funding or ERISA requirements
Bachelor's degree

What we offer:

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and 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:
June 12, 2025

Expiration:
June 20, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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