Appeal Examiner- Meritain Health
Multiple U.S. locationsFull-time$17–31.3/hrSeen todaySeen in employer's feed today
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At a glance
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Job overview
The Appeal Examiner manages complaint and appeal resolution across products, coordinating responses from multiple business units when needed. The role reviews assigned appeals, interprets policy and coverage guidelines, coordinates reviews, drafts resolution letters, and identifies trends and emerging issues. It requires customer service and administrative experience, working knowledge of Microsoft Office, and a high school diploma or GED.
Skills & qualifications
Skills
Qualifications
Benefits
Full 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
The Appeal Examiner is responsible for managing resolution and complaint/appeal scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/appeals. Identify trends and emerging issues and report and recommend solutions.
In this role, you will:
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Review and analyze any relevant appeals as assigned.
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Interpret any policy and coverage guidelines as dictated by organizational policy and supervisory discretion.
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Coordinate reviews as needed.
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Draft resolution letters in order to ensure a timely and accurate response.
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Ensure timely handling of assigned cases, contingent on departmental workload and assignments.
Required Qualifications
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1+ years customer service experience in a metrics driven environment.
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1+ years administrative experience.
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Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).
Preferred Qualifications
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1+ years of experience with plan documents, appeals, compliance and/or claim research.
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1+ year of experience with interpreting health plans and benefits.
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Strong familiarity with medical terminology, self-funding, and/or ERISA (Employee Retirement Income Security Act) requirements.
Education
- High school diploma or GED.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$17.00 - $31.30
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.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .
We anticipate the application window for this opening will close on: 11/06/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.
How this job compares
Set against the 795 open Claims Examiner jobs on Olive Jobs, counted November 3, 2026.
- Pay
- This posting$17–31.3/hr
- US median$19–29/hr47 hourly ranges
This range's midpoint, $24.15/hr, is close to the US median midpoint ($24/hr) — in the middle half of Claims Examiner hourly ranges across the US.
- Openings
- Olive Jobs lists 13 open Claims Examiner jobs in Arkansas and 795 across the US. 17% of them nationwide are listed as remote or flexible.
- Hiring the most across the US
- Sedgwick673 open
- Philadelphia Insurance Companies16 open
- CVS Health (this employer)13 open
- Experience
- This posting asks for at least 1 year of experience — less than three in four Claims Examiner postings that state a minimum ask for (median 5 years, across 769 postings).
- Education
- This posting asks for a high school diploma; 311 of the 795 open Claims Examiner jobs (39%) ask for a high school diploma or higher.
Counted across the open, public US postings on Olive Jobs on November 3, 2026. Pay medians are the middle values of the low ends and of the high ends of postings that list both ends of a range in the same cadence (a yearly salary or an hourly rate); a range's midpoint is halfway between its ends. Pay and experience figures resting on fewer than 20 postings are left out.
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