Intake Coordinator – Integrated Grievances and Appeals

Job not on LinkedIn

🔥 1 minute ago

🏈 Alabama, Arizona, +42 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $17 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 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 processing requirements from incoming information • Manage cases with varying turnaround times based on state, plan, and case type • Ensure urgent and expedited requests are handled timely • Partner with Quality Assurance 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 skills • Critical thinking skills • Data entry • Grievance and appeals experience • High School Diploma or equivalent • 1 year of grievance and appeals experience preferred • Medicare and Medicaid experience preferred • Intake experience preferred • Health insurance experience preferred • Ability to work 40 hours per week

🏖️ 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