Grievances & Appeals Intake Specialist

CVS Health; Montgomery (AL); On-site; USD 23,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Job summary

CVS Health is hiring for an Intake Specialist responsible for reviewing, researching, and entering grievance and appeal cases within one business day of receipt. You will monitor calls, faxes, emails, and mail, prioritizing requests and ensuring proper processing according to state, plan, and case type.

You will work closely with QA and participate in weekly team meetings to maintain accuracy and productivity.

Qualifications

• Minimum 2+ years of related experience in grievance and appeals.
• Strong problem-solving and decision-making skills.
• Excellent critical thinking and attention to detail.

Responsibilities

• Review 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 including member/provider grievances and appeals.
• Coordinate with QA to ensure accuracy and completeness of cases.
• Participate in weekly intake and project team meetings; adapt to changing procedures.

Skills

2+ years of related experience

Problem solving

Critical thinking

Data entry

Grievance and appeals experience

Education

High School Diploma or equivalent

Job description

CVS Health is hiring for an Intake Specialist responsible for reviewing, researching, and entering grievance and appeal cases within one business day of receipt. You will monitor calls, faxes, emails, and mail, prioritizing requests and ensuring proper processing according to state, plan, and case type.

You will work closely with QA and participate in weekly team meetings to maintain accuracy and productivity.