Health Care Intake & Appeals Specialist

CVS Health; Wisconsin; Sur place; USD 23 000 - 39 000; Plein temps

Résumé du poste

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 multiple intake sources—call tracking, fax, email, and mail—and prioritize requests to keep workloads handled promptly and accurately.

Responsibilities include determining case types, collaborating with QA, and supporting weekly team meetings. This is a full‑time role with a comprehensive benefits package.

Qualifications

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

Responsabilités

• 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 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.

Connaissances

Experience

Data entry

Grievance handling

Critical thinking

Decision making

Problem solving

Formation

High School Diploma or equivalent

Description du poste

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 multiple intake sources—call tracking, fax, email, and mail—and prioritize requests to keep workloads handled promptly and accurately.

Responsibilities include determining case types, collaborating with QA, and supporting weekly team meetings. This is a full‑time role with a comprehensive benefits package.