Help improve healthcare by supporting members through the appeals, complaints, and grievance process. This role is perfect for detail-oriented professionals who thrive in fast-paced environments and want to make a direct impact on patient care.
About CVS Health
CVS Health is the nation’s leading health solutions company, connecting millions of Americans with affordable, convenient, and compassionate care. With over 300,000 colleagues, we’re building a healthier world—one member at a time.
Schedule
- Full-time, 40 hours per week
- Remote, but must reside in Kentucky
- Standard business hours with potential for deadlines requiring quick turnarounds
What You’ll Do
- Intake, investigate, and resolve member/provider appeals, complaints, and grievances
- Research claims, eligibility, and benefit coverage to validate accuracy
- Coordinate responses across multiple business units to ensure timely resolution
- Draft and deliver final communications to members and providers
- Identify trends and recommend process improvements
- Serve as a subject matter resource to colleagues on appeals and grievance policies
What You Need
- High School Diploma or GED required (some college preferred)
- 1–2 years of experience in claims platforms, patient management, compliance, provider relations, or customer service
- Ability to research and interpret benefit language
- Strong analytical skills with attention to detail
- Excellent communication skills (written and verbal)
- Computer proficiency, including Excel and Word
- Ability to handle high-volume, deadline-driven work
Preferred Qualifications
- Experience with claims research and analysis
- Knowledge of clinical terminology, regulatory, and accreditation requirements
Benefits
- Competitive hourly pay: $17.00 – $25.65
- Affordable medical, dental, and vision plans
- 401(k) with company match + employee stock purchase plan
- Paid time off, flexible work schedules, and family leave
- Tuition assistance and career development programs
- Free wellness programs, including screenings and counseling
Take the next step in your healthcare career by joining a team committed to fairness, compassion, and meaningful results.
Happy Hunting,
~Two Chicks…