Healthcare Intake Coordinator - Grievances & Appeals

CVS Health; Sioux Falls (SD); On-site; USD 23,000 - 39,000; Full time

Job summary

CVS Health in the United States seeks a detail-oriented 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 accordingly.

This full-time role requires 2+ years of related experience, strong data entry and critical thinking skills, and expertise in grievance and appeals. Competitive benefits accompany a pay range of $17.00 to $28.46 per hour, with typical 40 hours per week.

Qualifications

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

Responsibilities

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

Skills

Data entry

Problem solving

Decision making

Critical thinking

Grievance and appeals experience

Education

High School Diploma or equivalent

Job description

CVS Health in the United States seeks a detail-oriented 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 accordingly.

This full-time role requires 2+ years of related experience, strong data entry and critical thinking skills, and expertise in grievance and appeals. Competitive benefits accompany a pay range of $17.00 to $28.46 per hour, with typical 40 hours per week.