Senior Coordinator, Complaint & Appeals

Job not on LinkedIn

🔥 1 hour ago

🎰 Nevada – Remote

🎰 Nevada – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• 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

🎯 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 • Ability to work 40 hours per week

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting the physical, emotional, and financial well-being of colleagues and their families • Growth and development opportunities • Collaborative team environment