Health Insurance Intake & Appeals Specialist

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

Job summary

CVS Health is seeking an Intake/Grievance Coordinator to review, research and enter grievance and appeal cases within one business day of receipt. You will monitor multiple intake sources, prioritize requests, and handle member/provider issues with accuracy and care.

The role requires 2+ years of related experience, strong problem solving and critical thinking skills, and data entry proficiency. A comprehensive benefits package and supportive team environment are provided.

Qualifications

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

Responsibilities

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor intake sources (call tracking, fax, email, mail) and prioritize requests.
• Intake various case types: member/provider grievances and appeals (pre-/post-service).
• Review information to determine the appropriate case type and processing requirements.
• Manage cases with varying turnaround times and requirements by state, plan, and type.
• Maintain organization to handle urgent requests and coordinate with QA.

Skills

Data entry

Problem solving

Decision making

Critical thinking

Grievance and appeals

Education

High School Diploma or Equivalent

Job description

CVS Health is seeking an Intake/Grievance Coordinator to review, research and enter grievance and appeal cases within one business day of receipt. You will monitor multiple intake sources, prioritize requests, and handle member/provider issues with accuracy and care.

The role requires 2+ years of related experience, strong problem solving and critical thinking skills, and data entry proficiency. A comprehensive benefits package and supportive team environment are provided.