Intake Coordinator, Integrated Grievances and Appeals

CVS Health; Maryland City (MD); Presencial; USD 23 000 - 39 000; Tempo integral

Resumo da oferta

CVS Health is seeking 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—call tracking, fax, email and mail—and prioritize accordingly.

You will handle member and provider grievances and appeals, determine processing requirements, and collaborate with QA and team leads to ensure accuracy and timely resolution.

Qualificações

• 2+ years of related experience in intake, grievances, or appeals.
• Experience with Medicare/Medicaid is a plus.
• Attention to detail and accuracy in processing.

Responsabilidades

• Review, research, and enter grievance and appeal cases within one business day.
• Monitor intake sources (call tracking, fax, email, mail) and prioritize.
• Intake various case types: member/provider grievances and appeals.
• Determine appropriate case type and processing requirements from information.
• Manage cases with varying turnaround times based on state, plan, and type.
• Maintain organization to ensure urgent requests are handled timely.
• Partner with QA to ensure entries are accurate and complete.
• Respond to QA questions and seek clarification when needed.
• Participate in weekly team meetings with Intake Coordinators, analysts, QA, managers.

Conhecimentos

Critical thinking

Data entry

Decision making

Formação académica

High School Diploma or equivalent

Descrição da oferta de emprego

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

• 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, which may include: Member appeals (pre-service)Member grievancesProvider grievancesProvider/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.

Required Qualifications

2+ years of related experience

Working knowledge or problem solving and decision making skills

Critical thinking skills

Data entry
Grievance and appeals experience

Preferred Qualifications

1 year of grievance and appeals experience

Medicare and Medicaid experience

Intake experience

Health insurance experience

Education

High School Diploma or equivalent

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $28.46

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments .

We anticipate the application window for this opening will close on: 11/13/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.