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Senior Coordinator, Complaint and Appeals at CVS Health - ApplyBlast

Senior Coordinator, Complaint and Appeals

CVS Health

6 days ago

3.2 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

The Senior Coordinator, Complaint and Appeals is responsible for reviewing, investigating, and resolving member complaints, appeals, and grievances. This role requires strong analytical and problem-solving skills to evaluate case information, research complex issues, and communicate clear and accurate determinations. The analyst works collaboratively with internal business partners to ensure cases are resolved accurately, timely, and in accordance with applicable policies and procedures.

Responsibilities

Review and investigate member complaints, appeals, and grievances
Analyze case information and benefit details to determine outcomes
Prepare accurate written correspondence for complaint and appeal determinations

Skills

About CVS Health

cvshealth.com

Headquarters

Woonsocket, Rhode Island, United States

Company Size

10001+ employees

Founded

1963

View Profile

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.