Senior Coordinator Complaint Appeals Operations - Remote

Job description

We’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. Position Summary: Responsible for managing to resolution appeal scenarios for all products, which contain multiple issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from standard processes to complete. Develop into a subject matter expert by providing training, coaching, or responding to complex issues. May have contact with outside plan sponsors or regulators. - Research and resolves incoming electronic appeals as appropriate as a “single-point-of-contact” based on type of appeal. - Can identify and reroute inappropriate work items that do not meet complaint/appeal criteria as well as identify trends in misrouted work. - Assemble all data used i...