Remote Appeals & Compliance Specialist

CVS Health Corporation; Nevada (IA); Hybrid; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical / Dental / Vision

Paid time off

Retirement savings

Wellness programs

Other resources

Job summary

CVS Health Corporation is seeking a dedicated analyst to ensure fair, compliant resolution of patient complaints, appeals and grievances. You will review cases, conduct in-depth analyses and draft decision letters.

This remote, full-time role requires 2–5 years of healthcare or compliance experience, strong analytical and communication skills, and attention to detail. The position offers a 40-hour week and a pay range of $18.50–$35.29 per hour, plus benefits.

Qualifications

• 2–5 years of relevant experience (healthcare, insurance, or compliance preferred).
• Strong analytical thinking and problem-solving skills.
• Attention to detail with the ability to interpret policies and regulations.
• Excellent communication and decision-making abilities.
• High school diploma or equivalent.

Responsibilities

• Review and manage patient complaints, appeals, and grievances, escalating complex cases as needed
• Conduct in-depth case analysis to identify errors, inconsistencies, or compliance gaps
• Coordinate and draft appeal decision letters, ensuring timely and accurate resolution
• Perform audits and monitor compliance with federal and state regulations
• Analyze KPIs to improve team performance and operational efficiency
• Support patient billing inquiries with accurate, responsive service
• Train, mentor, and guide team members on best practices and processes

Skills

Analytical thinking

Problem-solving

Attention to detail

Communication

Decision-making

Education

High school diploma

Job description

CVS Health Corporation is seeking a dedicated analyst to ensure fair, compliant resolution of patient complaints, appeals and grievances. You will review cases, conduct in-depth analyses and draft decision letters.

This remote, full-time role requires 2–5 years of healthcare or compliance experience, strong analytical and communication skills, and attention to detail. The position offers a 40-hour week and a pay range of $18.50–$35.29 per hour, plus benefits.