Help resolve complex complaints and appeals while ensuring timely, customer-focused responses that improve the member experience.
About CVS Health
CVS Health is the nation’s leading health solutions company, serving millions of Americans through local presence, digital channels, and 300,000+ colleagues nationwide. As part of the Customer Care team, you’ll address member concerns, identify trends, and recommend solutions that strengthen trust in our services.
Schedule
- Full-time, 40 hours per week
- Remote, open to candidates anywhere in the U.S.
- Standard weekday hours with flexibility based on business needs
What You’ll Do
- Manage resolution of complaints and appeals across products, often requiring input from multiple business units.
- Ensure timely, accurate, and customer-centered responses.
- Identify trends and emerging issues and recommend process improvements.
- Document all cases thoroughly to maintain compliance and accuracy.
What You Need
- High School Diploma or GED (required).
- 1+ year of experience working with both HMO and Traditional claim platforms.
- 1+ year of experience with Medicare, benefits, compliance, provider relations, customer service, or audits.
Preferred Qualifications
- Claims processing experience.
- Ability to read and research benefit language in SPDs or Certificates of Coverage.
- Background in claims research and analysis.
Benefits
- Pay range: $17.00 – $28.46/hour (based on experience, education, and location).
- Competitive salary plus bonus/short-term incentive eligibility.
- Medical, dental, and vision insurance.
- 401(k) with company match and employee stock purchase plan.
- Paid time off, flexible schedules, and family leave options.
- Wellness programs, financial coaching, tuition assistance, and retiree medical access (eligibility based).
Play a key role in ensuring fairness, compliance, and member satisfaction through expert resolution of complaints and appeals.
Happy Hunting,
~Two Chicks…