Senior Coordinator, Complaint & Appeals

Clinical Careers Page(1 month ago)

PennsylvaniaOnsiteFull TimeMedior$37,000 - $70,580Claims

About this role

An Appeals Specialist at CVS Health handles complex consumer and provider appeal cases across health products, acting as a single point of contact and coordinating with multiple business units. The role focuses on ensuring accurate interpretation of plan documents and claims data to support determinations and escalations, including interactions with regulatory agencies and executive-level complaints.

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Required Skills

Benefit Research
Claims Processing
Claims Research
Communication
Multitasking
Customer Service
Leadership
Workflow Documentation
Systems Navigation
Regulatory Knowledge

+1 more

Qualifications

High School Diploma

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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