Support patient rights and compliance by processing grievance and appeals cases with accuracy and empathy.
About CVS Health
CVS Health is the nation’s leading health solutions company, serving millions of Americans through local presence, digital channels, and a workforce of 300,000+ colleagues dedicated to connected, compassionate care.
Schedule
- Full-time, 40 hours per week
- Remote (Ohio residents only)
- Application window closes: October 21, 2025
What You’ll Do
- Enter grievance and appeals cases into the G&A system to launch research and resolution.
- Complete AOR (Appointment of Representative) process for applicable cases.
- Review and process appeals and grievances filed by patients.
- Conduct compliance audits, identify issues, and ensure adherence to policies.
- Draft and send appeal decision letters.
- Document billing questions, concerns, and case notes accurately.
- Assist with KPIs and reporting to track process effectiveness.
- Support development of training materials and coach junior staff.
What You Need
- High School Diploma required.
- Problem-solving and decision-making skills.
- Prior grievance and appeals experience.
Preferred Qualifications
- Experience in a health insurance call center environment.
Pay Range
- $17.00 – $25.65/hour
- Eligible for CVS Health bonus, commission, or incentive programs.
Benefits
- Affordable medical, dental, and vision plans.
- 401(k) with company match, employee stock purchase plan.
- Paid time off, flexible work schedules, family leave, dependent care resources.
- No-cost wellness programs (screenings, tobacco cessation, counseling, coaching).
- Tuition assistance and retiree medical access (eligibility varies).
CVS Health is an Equal Opportunity Employer, including Disability/Protected Veteran status. We are committed to fostering a diverse and inclusive workplace where every colleague feels valued.
Happy Hunting,
~Two Chicks…