Intake & Appeals Specialist

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

Job summary

CVS Health is hiring for a grievance intake specialist to review, research, and enter appeals and grievances with precision, within one business day of receipt. You will monitor multiple intake channels and prioritize urgent requests while maintaining accurate records.

The role emphasizes data integrity, collaboration with QA and colleagues, and adherence to evolving procedures. This full-time position offers comprehensive benefits and a stable schedule in Michigan.

Qualifications

• 2+ years of related experience.
• Working knowledge of problem solving and decision making.
• Critical thinking skills.
• Data entry and grievances/appeals experience.
• Preferred: Medicare and Medicaid experience.
• Intake experience and health insurance background.

Responsibilities

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor intake sources: call tracking, fax, email, and mail; prioritize requests.
• Intake various case types: member/provider grievances, pre/post-service appeals.
• Review information to determine case type and processing requirements.
• Manage cases with varying turnaround times based on state, plan, and case type.
• Collaborate with QA to ensure data accuracy and completeness.
• Respond to QA questions; seek clarification when needed.
• Participate in weekly team meetings with intake coordinators, analysts, QA, managers, and project managers.
• Adapt to changing procedures while maintaining accuracy and productivity.

Skills

Problem solving

Decision making

Data entry

Grievance handling

Grievance experience

Education

High School Diploma or equivalent

Job description

CVS Health is hiring for a grievance intake specialist to review, research, and enter appeals and grievances with precision, within one business day of receipt. You will monitor multiple intake channels and prioritize urgent requests while maintaining accurate records.

The role emphasizes data integrity, collaboration with QA and colleagues, and adherence to evolving procedures. This full-time position offers comprehensive benefits and a stable schedule in Michigan.