Intake & Appeals Specialist - Healthcare

CVS Health; Phoenix (AZ); On-site; USD 23,000 - 39,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health is hiring for an Intake/Grievance Coordinator in Phoenix, AZ. The role will review, research and enter grievance and appeal cases with speed and accuracy, while coordinating with QA and multiple intake channels.

The position requires 2+ years of related experience, strong data entry skills, and knowledge of grievance and appeals processes. This is a full-time on-site role with comprehensive benefits and a competitive pay range.

Qualifications

• 2+ years of related experience.
• Working knowledge of problem solving and decision making skills.
• Critical thinking skills.
• Data entry.
• Grievance and 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 closely with the Quality Assurance (QA) team to ensure cases are entered accurately and required information is complete.
• Respond to questions and feedback from QA and proactively seek clarification when needed.
• Participate in weekly team meetings with Intake Coordinators, analysts, Quality team members, managers, and project managers.
• Adapt quickly to changing procedures, requirements, priorities, and workflows while maintaining accuracy and productivity.

Skills

Data entry

Grievance and appeals

Critical thinking

Decision making

Problem solving

Education

High School Diploma or equivalent

Job description

CVS Health is hiring for an Intake/Grievance Coordinator in Phoenix, AZ. The role will review, research and enter grievance and appeal cases with speed and accuracy, while coordinating with QA and multiple intake channels.

The position requires 2+ years of related experience, strong data entry skills, and knowledge of grievance and appeals processes. This is a full-time on-site role with comprehensive benefits and a competitive pay range.