Intake Coordinator, Integrated Grievances and Appeals

CVS Health; Montpelier (VT); On-site; USD 23,000 - 39,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement plan

Job summary

CVS Health is seeking a grievance and appeals intake specialist to review, research, and enter cases within one business day of receipt. You will monitor multiple intake sources and prioritize requests to meet deadlines.

Responsibilities include classifying cases (member appeals, member grievances, provider grievances, provider/claim appeals), coordinating with QA, and participating in weekly team meetings to improve processes and accuracy.

Qualifications

• Minimum 2 years of related experience.
• Working knowledge of problem solving and decision making.
• Strong data entry proficiency.
• Grievance and appeals experience.

Responsibilities

• Review, research, and enter grievance and appeal cases within one business day of receipt.
• Monitor intake sources (call tracking, fax, email, mail) and prioritize requests.
• Intake various case types (member/grievances, provider grievances, appeals).
• Review information to determine case type and processing requirements.
• Maintain organization to handle urgent/expedited requests on time.
• Collaborate with QA to ensure accurate data entry and complete information.
• Answer questions and seek clarification from QA as needed.
• Participate in weekly team meetings with intake coordinators and managers.
• Adapt to changing procedures and priorities while maintaining accuracy.

Skills

Data entry

Critical thinking

Problem solving and decision making

Grievance and appeals experience

Education

High School Diploma or equivalent

Job description

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.

Benefits

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe 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.