Senior Coordinator, Complaint & Appeals - Remote

Clinical Careers Page(18 days ago)

NevadaOnsiteFull TimeMedior$37,000 - $70,580Healthcare/Insurance Claims Management

About this role

This role involves managing complex Fast Track Appeals for Medicare products, acting as a subject matter expert to ensure accurate resolution and compliance. The position requires coordinating responses across different units, researching claims, and maintaining high standards of customer service and regulatory adherence.

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Required Skills

CMS Guidelines
Appeals Processes
Claims Research
Regulatory Compliance
Customer Service
Medicare
Data Analysis
Claims Systems
Fiduciary Responsibility
Utilization Management

About Clinical Careers Page

cvshealth.com

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.

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