Senior Coordinator, Complaint & Appeals

CVS Health Corporation; Nevada (IA); Hybrid; USD 53,010,000 - 101,116,000; Full time

Job summary

CVS Health Corporation in the United States is seeking a Senior Coordinator for Complaint & Appeals. This remote, full-time role focuses on fair, compliant resolution of patient complaints, appeals, and grievances, with 40 hours per week.

You will review cases, draft decision letters, conduct audits for regulatory compliance, and mentor teammates while improving patient experience and KPI performance. The position offers a comprehensive benefits package and opportunities for growth; pay ranges

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.

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

Attention to detail

Communication skills

Decision making

Education

High school diploma or equivalent

Job description

## Senior Coordinator, Complaint & AppealsApply: Remote: NV - Work from home: Full time: Posted Yesterday: End Date: October 8, 2026 (5 days left to apply): R1053049We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.**Location:** Remote **Experience Level:** 2–5 years**Make an Impact**Join our team and play a key role in ensuring fair, compliant resolution of patient complaints, appeals, and grievances. You’ll help drive process excellence, safeguard regulatory compliance, and improve the overall patient experience.**What You’ll Do*** 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**What You Bring - Required*** 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**Why Join Us?*** Opportunity to make a meaningful difference in patient outcomes* Collaborative team environment with growth and development opportunities* Dynamic role combining analysis, compliance, and leadership**Anticipated Weekly Hours**40**Time Type**Full time**Pay Range**The typical pay range for this role is:$18.50 - $35.29This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.**Great benefits for great people**We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full‐time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‐being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on Benefits Moments.We anticipate the application window for this opening will close on: 10/08/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.