Senior Coordinator Complaint Appeals Operations
Clinical Careers Page(1 month ago)
About this role
A CVS Health Appeals Specialist focused on handling complex member and provider appeal scenarios across multiple products. The role acts as a subject-matter expert and liaison with internal teams, plan sponsors, and regulators to ensure accurate interpretation of benefits and coverage.
Required Skills
- Benefits Research
- Claims Research
- Customer Service
- Communication
- Leadership
- Workflow Documentation
- Regulatory Compliance
- Clinical Review
- Data Analysis
- Case Management
Qualifications
- High School Diploma
About Clinical Careers Page
cvshealth.comCVS 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.
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