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CVS Health Logo CVS Health · -

Senior Coordinator, Complaint and Appeals

United States, Work at Home Employment contract 18.50 - 35.29 USD / Hour · Job Posted May 31, 2026
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Job Description

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.

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 year experience that includes both HMO and Traditional claim platforms, products, and benefits, patient management, product, compliance and regulatory analysis, special investigations, provider relations, customer service or audit experience
  • High School or Equivalent

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 a plus

What we offer

  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
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