Healthcare Intake & Appeals Specialist

CVS Health; Lansing (MI); Sur place; USD 23 000 - 39 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health is hiring to support grievance and appeal processing within a fast-paced health services environment. You will review cases, research details, and enter information within one business day of receipt, while coordinating with QA and a cross-functional team to ensure accurate processing.

The role emphasizes data accuracy, prioritization of urgent requests, and collaboration in a dynamic setting with weekly team meetings and evolving procedures.

Qualifications

• Experience handling grievance/appeals in health or insurance settings.
• Ability to assess information and decide appropriate action.
• Attention to detail and accuracy in data entry.
• Familiarity with intake and escalation processes.

Responsabilités

• 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 including member/provider grievances and appeals.
• Determine case type and applicable processing requirements.
• Maintain organization and prioritize urgent requests for timely handling.
• Collaborate with QA to ensure accuracy and completeness of cases.
• Participate in weekly team meetings with intake coordinators, analysts, QA, managers, and project managers.
• Adapt to changing procedures and workflows while maintaining accuracy and productivity.

Connaissances

2+ years of experience

Problem solving skills

Critical thinking

Data entry

Grievance and appeals experience

Formation

High School Diploma or equivalent

Description du poste

CVS Health is hiring to support grievance and appeal processing within a fast-paced health services environment. You will review cases, research details, and enter information within one business day of receipt, while coordinating with QA and a cross-functional team to ensure accurate processing.

The role emphasizes data accuracy, prioritization of urgent requests, and collaboration in a dynamic setting with weekly team meetings and evolving procedures.