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Senior Appeals Examiner
Senior Appeals ExaminerCVS Health • Tallahassee, FL, US
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Senior Appeals Examiner

Senior Appeals Examiner

CVS Health • Tallahassee, FL, US
1 day ago
Job type
  • Full-time
Job description

Senior Appeals Examiner – CVS Health

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.

Position Summary

Responsible for managing resolution complaint / appeal scenarios for all products, ensuring timely, customer-focused responses to complaints / appeals. Identify trends, emerging issues and report and recommend solutions.

Required Qualifications

  • 1+ years knowledge of plan documents, claims research, letter writing.
  • 1+ years working with appeals, claims, or compliance.
  • 1+ years experience working with documenting and interpreting Health Insurance plans.
  • Understand excel and word.
  • Able to interpret benefits.
  • Healthcare experience.

Preferred Qualifications

  • 3+ years of prior claim or health insurance experience.
  • Familiarity with medical terminology, self funding or ERISA requirements.
  • Education

  • Associate Degree or High School Diploma / GED and equivalent experience.
  • Pay Range, Hours, Type

    Typical pay range : $18.50 - $42.35 per hour. 40 hours per week. Full-time.

    Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
  • Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

    Application window closes 10 / 31 / 2025.

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    Examiner • Tallahassee, FL, US

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