Intake & Appeals Specialist - Health Insurance

CVS Health; Annapolis (MD); On-site; USD 23,000 - 39,000; Full time

Job summary

CVS Health is seeking an Intake Coordinator to handle grievance and appeal cases, ensuring timely entry and accurate processing across diverse intake sources. The role supports a health-focused team and contributes to improved member and provider experiences.

Ideal candidates bring 2+ years in grievance/appeals, data entry precision, and strong problem-solving skills, with a proactive approach to prioritization and collaboration across QA and operations in a fast-paced environment.

Qualifications

• 2+ years of related experience in health care or member services.
• Experience with grievance and appeals processes.
• Attention to detail and data entry accuracy.
• Ability to prioritize and manage multiple intake sources.

Responsibilities

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

Skills

2+ yrs exp

Problem solving

Critical thinking

Data entry

Grievance & appeals

Education

High School Diploma or equivalent

Job description

CVS Health is seeking an Intake Coordinator to handle grievance and appeal cases, ensuring timely entry and accurate processing across diverse intake sources. The role supports a health-focused team and contributes to improved member and provider experiences.

Ideal candidates bring 2+ years in grievance/appeals, data entry precision, and strong problem-solving skills, with a proactive approach to prioritization and collaboration across QA and operations in a fast-paced environment.