Intake Coordinator – Integrated Grievances and Appeals

Job not on LinkedIn

🔥 2 hours ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $17 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

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

🎯 Requirements

• 2+ years of related experience • Working knowledge of problem solving and decision making • Critical thinking skills • Data entry • Grievance and appeals experience • High School Diploma or equivalent • Ability to manage varying turnaround times and requirements based on state, plan, and case type • Ability to handle urgent and expedited requests timely • Preferred: Medicare and Medicaid experience • Preferred: Intake experience • Preferred: Health insurance experience • Preferred: 1 year of grievance and appeals experience

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility • Comprehensive benefits package for full-time colleagues

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