Grievances & Appeals Intake Specialist

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

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an intake specialist to review, research, and enter grievance and appeal cases within one business day. You will monitor multiple intake sources, triage requests, and determine the appropriate processing requirements to ensure timely handling.

The role emphasizes accuracy, organization, and timely handling of urgent requests, with 2+ years of related experience and data entry skills. Medicare/Medicaid exposure is a plus.

Qualifications

• 2+ years of related experience.
• Working knowledge of problem solving and decision making.
• Critical thinking skills.
• Data entry and grievance/appeals experience.
• Preferred: 1 year of grievance and appeals experience.
• Preferred: Medicare and Medicaid experience.
• Preferred: Intake experience.
• Preferred: Health insurance experience.

Responsibilities

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor multiple intake sources and prioritize requests.
• Intake various case types including member/provider grievances and appeals.
• Review information to determine case type and processing requirements.
• Manage cases with varying turnaround times while maintaining accuracy.
• Maintain organization to ensure urgent requests are handled timely.
• Partner with QA to ensure accurate data entry and complete information.
• Respond to QA questions and seek clarification as needed.
• Participate in weekly intake team meetings and adapt to changing procedures.

Skills

2+ years of related experience

Problem solving

Decision making

Critical thinking

Data entry

Grievance and appeals experience

Education

High School Diploma or equivalent

Job description

CVS Health is seeking an intake specialist to review, research, and enter grievance and appeal cases within one business day. You will monitor multiple intake sources, triage requests, and determine the appropriate processing requirements to ensure timely handling.

The role emphasizes accuracy, organization, and timely handling of urgent requests, with 2+ years of related experience and data entry skills. Medicare/Medicaid exposure is a plus.