CVS Health
Appeal and Grievance Coordinator - MUST live in KY, OK, and OH
LA - Work from home · Remote · Full-time · Posted Oct 19, 2026
- Experience
- 1–2 years in one or more of the listed areas, including claim platforms, products and benefits; patient management; product or contract drafting; compliance and regulatory analysis; special investigations; provider relations; customer service; or audit.
- Education
- High School or GED equivalent.
About the job
Coordinates the intake, investigation, and resolution of member and provider appeals, complaints, and grievances, including research, cross-team coordination, and final communications.
What you'll do
- Research and route incoming appeals, investigate benefit and claim issues, and identify all components requiring resolution.
- Coordinate responses with other business units and communicate final resolutions to members or providers.
- Identify trends and emerging issues, report findings, and recommend potential solutions.
What they ask for
- Experience reading or researching benefit language.
- Strong analytical skills, accuracy, and attention to detail.
- Knowledge of clinical terminology and regulatory and accreditation requirements.
- Computer literacy, including Excel and Microsoft Word.
Nice to have
- Experience researching and analyzing claim processing.
- Some college.
Pay
$17.00 - $25.65 USD base hourly rate or base annual full-time salary
Tools
Excel, Microsoft Word
Model-written summary · the original posting is authoritative