Senior Coordinator Complaint Appeals Operations - Remote

Overview

The Senior Coordinator Complaint Appeals Operations at CVS Health is responsible for managing complex appeal scenarios across multiple products, ensuring resolution through effective coordination and expertise.

In Short

• Manage resolution of complex appeal scenarios.
• Act as a subject matter expert in appeals processes.
• Research and resolve incoming electronic appeals.
• Identify trends in misrouted work items.
• Coordinate efforts across departments for claims resolution.
• Deliver internal quality reviews and support audits.
• Educate team members on complaints and appeals.
• Handle executive complaints and regulatory inquiries.
• Document workflows and reengineering efforts.
• Provide excellent customer service and communication.

Requirements

• 1 year experience in benefit language research.
• Excellent verbal and written communication skills.
• Strong leadership and multitasking abilities.
• Experience in claims processing analysis preferred.
• Project management skills are a plus.
• High School Diploma required.

Benefits

• Affordable medical plan options.
• 401(k) plan with company matching.
• No-cost wellness programs.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave options.
• Employee stock purchase plan.