Complaint and Appeals Analyst - Fully Remote

Lensa; Jackson (MS); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is seeking a Complaint and Appeals Analyst for CVS Health. This fully remote position involves researching grievances and appeals for dual eligible members, requiring at least 1 year of experience in health insurance processes. Comprehensive benefits and a competitive hourly rate are offered.

Benefits

Comprehensive medical plans

401(k) with matching

Stock purchase plans

Wellness programs

Paid time off

Flexible schedules

Family leave

Tuition assistance

Qualifications

• 1 year of experience processing health insurance grievance and appeal cases.
• 6+ years of experience in Medicare and Medicaid appeal processes preferred.

Responsibilities

• Research and process grievances and appeals for Dual eligible members.
• Perform outreach to obtain additional information.
• Interact with Medical Directors, Nurses, and Leadership.

Skills

Health insurance grievance processing

Appeal case management

Education

High School Diploma or GED

Job description

Complaint and Appeals Analyst - Fully Remote

Be among the first 25 applicants one day ago

Lensa is the leading career site for job seekers at every stage of their career. Our client, CVS Health, is seeking professionals. Apply via Lensa today!

At CVS Health, we’re building a world of health around every consumer, surrounded by dedicated colleagues passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels, and more than 300,000 purpose-driven colleagues – caring for people where, when, and how they choose in a way that is uniquely more connected, more convenient, and more compassionate. And we do it all with heart, each and every day.

Position Summary

Research and process grievances and appeals for Dual eligible members and providers. Perform outreach to obtain additional information. Interact with Medical Directors, Nurses, and Leadership.

Required Qualifications

• 1 year of experience processing health insurance grievance and appeal cases.

Preferred Qualifications

• 6+ years of experience in Medicare and Medicaid appeal and grievance processes preferred.

Education

• High School Diploma or GED required.

Additional Details

• Anticipated Weekly Hours: 40
• Time Type: Full time
• Pay Range: $21.10 - $44.99 per hour

This pay range represents the base hourly rate or salary, with the actual offer depending on experience, education, geography, and other factors. This role is eligible for bonuses, commissions, or incentives.

Benefits

We offer comprehensive benefits including medical plans, 401(k) with matching, stock purchase plans, wellness programs, paid time off, flexible schedules, family leave, tuition assistance, and more. For details, visit https://jobs.cvshealth.com/us/en/benefits

Application deadline: 06/04/2025

We consider qualified applicants with arrest or conviction records in accordance with laws. We are an equal opportunity employer, committed to diversity and inclusion.