Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary
Responsible for managing to resolution complaint/appeal 
scenarios for all products, which may contain multiple issues 
and may require coordination of responses from multiple 
business units. Ensure timely, customer focused response to 
complaints/appeals. Identify trends and emerging issues and 
report and recommend solutions.
This position can be anywhere in the United States.

Required Qualifications
1 year experience that includes both HMO and Traditional 
claim platforms, products, and benefits, patient management, 
product, compliance and regulatory analysis, special 
investigations, provider relations, customer service or audit 
experience.

Preferred Qualifications
Medicare experience
Claims experience
Experience in reading or researching benefit language in 
Summary Plan Description (SPDs) or Certificate of Coverage 
(COCs)
Experience in research and analysis of claim processing a plus.

Education
High School or Equivalent

Pay Range

The typical pay range for this role is:

$17.00 - $25.65

This 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.  
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 09/30/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.