Senior Coordinator, Complaint and Appeals (Remote) jobs in United States
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CVS Health · 2 hours ago

Senior Coordinator, Complaint and Appeals (Remote)

CVS Health is dedicated to building a world of health around every individual, and they are seeking a Senior Coordinator, Complaint and Appeals to join their remote team. In this role, you will support the daily operations of the Commercial Member Clinical Appeals team by processing appeal determination letters and managing intake requests.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Processing appeal determination letters, managing intake and expedited requests, updating internal systems, and generating reports
Supporting panel hearings and collaborating with clinical staff (Medical Directors, Nurses, Providers, etc)
Additional duties involve triaging incoming faxes and managing case movement within the Complaints and Appeals Tracking System (CATS)
Completing tasks in accordance with regulatory standards and required turnaround times
This is a full-time telework position with standard hours of Monday–Friday, 8:00 AM to 5:00 PM (local time)
Occasional weekend and holiday on-call coverage may be required

Qualification

Healthcare appeals experienceMicrosoft Office SuiteWritten communication skillsVerbal communication skillsTask management

Required

Strong written and verbal communication skills
Ability to manage multiple tasks efficiently
Proficiency in Microsoft Office Suite and basic computer skills
High School Diploma required

Preferred

1–2 years of experience in healthcare appeals, grievances, or a related administrative role
1+ year working in a healthcare setting (e.g., insurance, hospital administration, or clinical support)
Experience with the appeals process or related work

Benefits

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
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Company

CVS Health

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CVS Health is a health solutions company that provides an integrated healthcare services to its members.

Funding

Current Stage
Public Company
Total Funding
$4B
Key Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity

Leadership Team

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David Joyner
President and Chief Executive Officer, CVS Health
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Chandra McMahon
SVP & CISO
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Company data provided by crunchbase