Health Plan Appeals Specialist

CVS Health; Carson City (NV); On-site; USD 23,000 - 43,000; Full time

Benefits offered by this job

Benefits package

Bonus eligibility

Paid time off

Job summary

CVS Health in Carson City, Nevada, is seeking an Appeal Examiner to manage resolution and complaint/appeal scenarios across products, coordinating with multiple business units to ensure timely, customer-focused responses.

You will review appeals, interpret policy guidelines, coordinate reviews, and draft timely resolution letters, with a 40-hour workweek and pay range of $17.00–$31.30 per hour; eligibility for bonus and benefits.

Qualifications

• 1+ years customer service experience in a metrics-driven environment.
• 1+ years administrative experience.
• Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).

Responsibilities

• Review and analyze relevant appeals as assigned.
• Interpret policy and coverage guidelines per organizational policy.
• Coordinate reviews as needed.
• Draft resolution letters to ensure timely, accurate responses.
• Ensure timely handling of assigned cases based on workload.

Skills

Customer service

Administrative experience

Microsoft Office

Education

High school diploma or GED

Tools

Microsoft Office Suite

Job description

CVS Health in Carson City, Nevada, is seeking an Appeal Examiner to manage resolution and complaint/appeal scenarios across products, coordinating with multiple business units to ensure timely, customer-focused responses.

You will review appeals, interpret policy guidelines, coordinate reviews, and draft timely resolution letters, with a 40-hour workweek and pay range of $17.00–$31.30 per hour; eligibility for bonus and benefits.