# Appeals, Complaints and Grievances Specialist

**Company**: CVS Health
**Location**: LA, LA
**Job type**: full-time
**Salary**: $17.00 - $25.65 per hour
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/LA---Work-from-home/Appeal-and-Grievance-Coordinator---MUST-live-in-KY--OK--and-OH_R1047720?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/appeals-complaints-and-grievances-specialist-3df19cd7-d30/

## Description

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

Responsible for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products. You will ensure timely, customer-focused responses to appeals, complaints and grievances, identifying trends and emerging issues, and recommending solutions.

Key Responsibilities:

- Research incoming electronic appeals, complaints and grievances to identify if they're appropriate for your unit.

- Verify accuracy of benefit/administrative denials, claim payments, and member eligibility data.

- Coordinate responses from multiple business units and communicate final resolutions to members/providers.

- Serve as a technical resource to colleagues on appeals, complaints and grievance issues.

- Identify trends and emerging issues, reporting and giving input on potential solutions.

Requirements:

- Experience in reading or researching benefit language.

- 1-2 years of experience in claim platforms, products, benefits, patient management, or related fields.

- Strong analytical skills, attention to detail, and excellent verbal and written communication skills.

- Computer literacy in Excel, Microsoft Word, and internal/external computer systems.

Preferred Qualifications:

- Experience in research and analysis of claim processing.

Benefits:

- Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, and wellness programs.

Salary Range: $17.00 - $25.65 per hour

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## Skills

### Required
- benefit language
- claim platforms
- analytical skills
- Excel
- Microsoft Word

### Nice to have
- claim processing

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/LA---Work-from-home/Appeal-and-Grievance-Coordinator---MUST-live-in-KY--OK--and-OH_R1047720?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)