Impactful Appeals & Grievance Coordinator

CVS Health; Lexington (KY); On-site; USD 23,000 - 43,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking an Appeals Specialist to manage intake, research, and resolution of member appeals, complaints, and grievances. You will coordinate with multiple teams to ensure accurate responses and timely closures, while identifying trends and regulatory considerations in a high-paced environment.

The role requires 1–2 years of related experience, familiarity with benefit language, and strong analytical and communication skills.

Qualifications

• Experience with reading or researching benefit language.
• Patient management or claims-related experience is a plus.

Responsibilities

• Handle intake, investigation, and resolution of appeals, complaints and grievances.
• Coordinate responses across business units to ensure timely, customer-focused resolution.

Skills

Benefit language experience

Education

Some college preferred.

High School or GED equivalent.

Job description

CVS Health is seeking an Appeals Specialist to manage intake, research, and resolution of member appeals, complaints, and grievances. You will coordinate with multiple teams to ensure accurate responses and timely closures, while identifying trends and regulatory considerations in a high-paced environment.

The role requires 1–2 years of related experience, familiarity with benefit language, and strong analytical and communication skills.