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AA2IT

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Complaint and Appeal Analyst

Sturtevant, WI · On-site

$24 - $26/hr

Conduct statistical analysis of complaint trends. * Support training program by training users on the complaint process and tools used to assess and investigate complaints. Process Improvement ...

CVS Health

Senior Manager - Complaint & Appeals

$75K - $165K/yr

Analyze training needs to develop appropriate resources and successfully enhance the company ... Appeal and Grievance Experience * NCQA or EQRO Audit experience Education * Bachelor's degree ...

Independent Health Association

$22.50 - $27.50/hr

Ability to analyze problems systematically, organize information, identify underlying causes and ... Information gathered in appeal/complaint activity is relied upon for internal and external ...

Independent Health

Contractual Reviewer-Senior

Buffalo, NY · On-site

$22.50 - $27.50/hr

Ability to analyze problems systematically, organize information, identify underlying causes and ... Information gathered in appeal/complaint activity is relied upon for internal and external ...

TRILLIUM HEALTH RESOURCES

Appeals Specialist II

NC · Remote

$56K - $69K/yr

Manage assigned appeals, grievances, and/or complaint cases from intake through resolution. * Investigate cases by gathering documentation, interviewing stakeholders, and analyzing findings.

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Complaint And Appeal Analyst information

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How much do complaint and appeal analyst jobs pay per month?

As of Aug 31, 2026, the average monthly pay for complaint and appeal analyst in the United States is $6,591.00, according to ZipRecruiter salary data. Most workers in this role earn between $6,208.33 and $6,958.33 per month, depending on experience, location, and employer.

What does a Complaint and Appeal Analyst do?

A Complaint and Appeal Analyst is responsible for reviewing, investigating, and resolving complaints and appeals submitted by customers or clients, often within healthcare, insurance, or financial industries. They analyze complex cases, ensure compliance with regulations and company policies, and communicate resolutions to all involved parties. Their goal is to ensure fair outcomes and improve customer satisfaction while maintaining accurate records and supporting process improvements.

What are the key skills and qualifications needed to thrive as a Complaint and Appeal Analyst?

To excel as a Complaint and Appeal Analyst, you need strong analytical abilities, attention to detail, and knowledge of relevant regulations, often supported by a bachelor's degree in a related field. Familiarity with case management software, claims processing systems, and regulatory databases is typically required. Outstanding written communication, problem-solving, and customer service skills help analysts effectively resolve complex issues and interact with stakeholders. These competencies are crucial for ensuring compliance, fair resolution of appeals, and maintaining organizational trust and customer satisfaction.

How does a Complaint and Appeal Analyst typically interact with other departments within an organization?

A Complaint and Appeal Analyst regularly collaborates with multiple departments such as customer service, legal, compliance, and clinical teams to thoroughly investigate and resolve complaints or appeals. This cross-functional interaction ensures that all aspects of a case—be it regulatory requirements, policy guidelines, or customer concerns—are addressed comprehensively. Effective communication and teamwork are essential, as analysts often need to gather information, clarify details, and coordinate resolution efforts with various stakeholders. This collaborative environment also offers opportunities to learn from other functions and broaden one's understanding of the organization.
Complaint And Appeal Analyst jobs near you

Complaint and Appeal Analyst

Sturtevant, WI • On-site

AA2IT
IT Services • 11 - 50 employees
Learn more about AA2ITexternal

$24 - $26/hr

Contractor

Medical, Dental, Vision

Posted 5 days ago

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Job description

HCR0003271
Title: Product Surveillance Associate
Pay Rate: 24-26/HR on W2
Location: Sturtevant, WI 53177
The Product Surveillance Associate III performs day-to-day tasks and provides technical data assessment of post-market events and can support the Quality Department with Quality System activities including Change Control and Client/CAPA. This position plays an integral role in maintaining compliance with global regulations. The Product Surveillance Specialist V works with minimal supervision and requires a high degree of interaction with customers, health care professionals, global government agencies, and Global Merz employees at all levels within the organization.
Work Environment:
Onsite Required
Overtime limited
Must be able to pass vision testing requirements at 20/20 near acuity vision (with or without corrective eyewear).
Key Responsibilities:
• Independently field inquiries received by phone, electronic or verbal correspondence and determine if it qualifies as a complaint; document reported issues according to applicable SOP(s).
• Provide technical support and remote troubleshooting guidance as needed.
• Independently review associated records, and contact users and customers to collect information on the treatment, product performance, functionality, etc.
• Conduct periodic follow-up to close complaints in a timely manner.
• Manage customer relationship and expectations during the course of the complaint investigation.
• Independently complete investigations, which may include execution or coordination of product returns and subsequent evaluations, review of manufacturing records and ensuring proper approvals are obtained as part of closure.
• Develop solutions to a variety of moderate problems.
• Conduct statistical analysis of complaint trends.
• Support training program by training users on the complaint process and tools used to assess and investigate complaints.
Process Improvement Initiatives:
• Supports and may identify operational changes to improve efficiencies in all aspects of complaint handling.
• Support and sometimes lead investigations associated with product deviations, product non-conformances, CAPAs, scrap and rework, and analyzing the data for the reasons of Quality Improvement and reporting.
• Update internal operating procedures and specifications through the Document Change process.
Compliance Initiatives:
• Support and participate in internal quality system audits. Support external quality system audits.
• Evaluate complaints and determine if the submission of a Medical Device Report (MDR) or other Vigilance Report is required.
• Support submitting MDRs and Vigilance Reports according to regulatory timelines.
Education (required):
High School Diploma with 4 years of experience OR Associate's Degree with 2 years of experience OR Bachelor's Degree
Work Experience:
Medical or Surgical Office Experience (preferred)
Customer Service Experience (preferred)
Knowledge, Skills, Abilities:
• Familiar with ISO 13485 Quality System Standards, FDA Quality System Regulations, GMPs, and/or other international medical device regulations.
• Basic medical and/or scientific terminology.
• Highly organized with attention to detail.
• Strong ability to prioritize and manage multiple records/reports simultaneously.
• Professional phone etiquette with the ability to appropriately handle sensitive information.
• Effective communication skills including written and verbal.
• Ability to work with company staff and communicate effectively throughout the organization.
• Proficient in Microsoft Office Suite.

Company Description

At AA2IT, we deliver solutions that align with your business goals, built on innovation, backed by a team of experts, and guided by measurable outcomes.