Grievances & Appeals Intake Specialist

CVS Health; Lexington (KY); 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 of receipt. You will monitor call tracking, fax, email, and mail sources, prioritize requests, and classify cases by type and processing requirements.

You will work with QA to ensure data accuracy and completeness, and participate in weekly meetings with intake coordinators, analysts, QA, managers, and project managers to adapt to evolving procedures while maintaining

Qualifications

• 2+ years of related experience.
• Working knowledge of problem solving and decision making.
• Strong critical thinking skills.
• Data entry.
• Experience with grievances and appeals.

Responsibilities

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor multiple intake sources (call tracking, fax, email, mail) and prioritize requests.
• Intake various case types (member/provider grievances, appeals) and determine processing requirements.
• Maintain organization and prioritization for urgent/expedited requests.
• Collaborate with QA to ensure accuracy and completeness of entries and information.
• Participate in weekly team meetings with Intake Coordinators, analysts, QA, and project managers.

Skills

2+ years experience

Data entry

Problem solving

Critical thinking

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 of receipt. You will monitor call tracking, fax, email, and mail sources, prioritize requests, and classify cases by type and processing requirements.

You will work with QA to ensure data accuracy and completeness, and participate in weekly meetings with intake coordinators, analysts, QA, managers, and project managers to adapt to evolving procedures while maintaining