Healthcare Intake & Appeals Coordinator

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

Benefits offered by this job

Comprehensive benefits

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement options

Job summary

CVS Health is seeking a dedicated Intake Analyst to process grievance and appeal cases promptly. You will monitor multiple sources, prioritize requests, and classify cases by type while ensuring accuracy and timely handling.

The role involves coordinating with QA and attending weekly cross-functional meetings in a fast-paced benefits environment. The ideal candidate has 2+ years of related experience, strong data entry and critical thinking skills, and familiarity with grievance/appeal workflows

Qualifications

• 2+ years of related experience
• Working knowledge or problem solving and decision making skills
• 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 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 grievances Provider grievances Provider/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 Quality Assurance (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.

Skills

Data entry

Critical thinking

Problem solving

Decision making

Education

High School Diploma or equivalent

Job description

CVS Health is seeking a dedicated Intake Analyst to process grievance and appeal cases promptly. You will monitor multiple sources, prioritize requests, and classify cases by type while ensuring accuracy and timely handling.

The role involves coordinating with QA and attending weekly cross-functional meetings in a fast-paced benefits environment. The ideal candidate has 2+ years of related experience, strong data entry and critical thinking skills, and familiarity with grievance/appeal workflows