Grievances & Appeals Intake Specialist

CVS Health; New York (NY); Sur place; USD 23 000 - 39 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health in New York seeks an Intake Coordinator to review, research, and enter grievance and appeal cases within one business day of receipt. You will monitor multiple intake sources and prioritize requests to ensure timely processing.

You will handle member and provider grievances and appeals, determine processing requirements, and work with QA to maintain accuracy. This full-time role offers comprehensive benefits and a stable health-care environment.

Qualifications

• 2+ years of related experience in a similar role.
• Strong problem solving and decision-making skills.
• Critical thinking abilities.
• Proficient data entry skills.
• Experience with grievances and appeals.

Responsabilités

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor intake sources (call tracking, fax, email, and mail) and prioritize requests.
• Intake various case types including member and provider grievances and appeals.
• Determine appropriate case type and processing requirements.
• Manage cases with varying turnaround times based on state, plan, and type.
• Maintain organization to handle urgent and expedited requests.
• Partner with QA to ensure accurate entry and complete information.
• Respond to QA questions and seek clarification when needed.
• Participate in weekly team meetings with Intake Coordinators, analysts, QA, managers, and project managers.
• Adapt to changing procedures while maintaining accuracy and productivity.

Connaissances

2+ years of related experience

Problem solving

Critical thinking

Data entry

Grievance and appeals experience

Formation

High School Diploma or equivalent

Description du poste

CVS Health in New York seeks an Intake Coordinator to review, research, and enter grievance and appeal cases within one business day of receipt. You will monitor multiple intake sources and prioritize requests to ensure timely processing.

You will handle member and provider grievances and appeals, determine processing requirements, and work with QA to maintain accuracy. This full-time role offers comprehensive benefits and a stable health-care environment.