Senior Coordinator, Complaint & Appeals

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.

Join our team and play a key role in ensuring fair, compliant resolution of patient complaints, appeals, and grievances. You’ll help drive process excellence, safeguard regulatory compliance, and improve the overall patient experience.

• →Review and manage patient complaints, appeals, and grievances, escalating complex cases as needed
• →Conduct in-depth case analysis to identify errors, inconsistencies, or compliance gaps
• →Coordinate and draft appeal decision letters, ensuring timely and accurate resolution
• →Perform audits and monitor compliance with federal and state regulations
• →Analyze KPIs to improve team performance and operational efficiency
• →Support patient billing inquiries with accurate, responsive service
• →Train, mentor, and guide team members on best practices and processes

• 2–5 years of relevant experience (healthcare, insurance, or compliance preferred)
• Strong analytical thinking and problem-solving skills
• Attention to detail with the ability to interpret policies and regulations
• Excellent communication and decision-making abilities
• High school diploma or equivalent

The typical pay range for this role is:

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.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.