Grievance & Appeal Intake Specialist

CVS Health; Maryland; On-site; USD 23,000 - 39,000; Full time

Job summary

CVS Health is seeking a detail‑oriented Intake Coordinator to handle grievance and appeal processing in a fast-paced environment. You will review information from multiple sources, classify cases, and ensure accurate entry while meeting tight turnaround times.

The role requires 2+ years of related experience, strong data-entry and problem-solving skills, and a commitment to accuracy. This full-time position offers comprehensive benefits and growth opportunities in a healthcare setting.

Qualifications

• 2+ years of related experience.
• Working knowledge or problem solving and decision making skills.
• Critical thinking skills.
• Data entry Grievance and appeals experience.

Responsibilities

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor multiple intake sources, including call tracking, fax, email, and mail, and appropriately prioritize incoming requests.
• Intake various case types, which may include: Member appeals (pre-service)Member grievancesProvider grievancesProvider/claim appeals (post-service).
• Review incoming information to determine the appropriate case type and applicable processing requirements.
• Manage cases with varying turnaround times and requirements based on state, plan, and case type.
• Maintain strong organization and prioritization to ensure urgent and expedited requests are handled timely.
• Partner closely with the Quality Assurance (QA) team to ensure cases are entered accurately and required information is complete.
• Respond to questions and feedback from QA and proactively seek clarification when needed.
• Participate in weekly team meetings with Intake Coordinators, analysts, Quality team members, managers, and project managers.
• Adapt quickly to changing procedures, requirements, priorities, and workflows while maintaining accuracy and productivity.

Skills

Data entry

Decision making

Critical thinking

Grievance and appeals

Education

High School Diploma

Job description

CVS Health is seeking a detail‑oriented Intake Coordinator to handle grievance and appeal processing in a fast-paced environment. You will review information from multiple sources, classify cases, and ensure accurate entry while meeting tight turnaround times.

The role requires 2+ years of related experience, strong data-entry and problem-solving skills, and a commitment to accuracy. This full-time position offers comprehensive benefits and growth opportunities in a healthcare setting.