Intake & Appeals Specialist (Healthcare)

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Job summary

CVS Health is seeking an Intake Coordinator to review, research, and enter grievance and appeal cases within one business day of receipt. The role requires monitoring multiple intake sources and prioritizing requests across various case types.

The ideal candidate will have 2+ years of related experience, strong data entry and problem-solving skills, and the ability to adapt to changing procedures while ensuring accuracy. This full-time position offers comprehensive benefits.

Qualifications

• 2+ years of related experience.
• Working knowledge of problem solving and decision making.
• Critical thinking skills.
• Data entry and grievance/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, including 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 with the QA team to ensure cases are entered accurately and information is complete.
• Respond to questions 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 and workflows while maintaining accuracy and productivity.

Education

High School Diploma or equivalent

Job description

CVS Health is seeking an Intake Coordinator to review, research, and enter grievance and appeal cases within one business day of receipt. The role requires monitoring multiple intake sources and prioritizing requests across various case types.

The ideal candidate will have 2+ years of related experience, strong data entry and problem-solving skills, and the ability to adapt to changing procedures while ensuring accuracy. This full-time position offers comprehensive benefits.