Complaints & Appeals Intake Coordinator (Must reside in Arizona)
CVS Health, Phoenix, AZ, United States
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
The Complaints & Appeals Intake Coordinator prepares information and reports needed to address matters regarding complaints, appeals, and grievances. This person carries out policies, procedures, and programs to ensure compliance with federal and/or state regulations.
What You Will Do
Review, interpret, and process appeals and grievances filed by patients, escalating more complex issues and concerns to management for review and follow-up.
Perform patient and insurance report analysis and identify any trends or issues that need to be addressed.
Conduct reviews of decisions and case files to determine if there are any errors or anomalies in the application of law or evidence.
Draft and send appeal decision letters, conducting detailed follow-up for timely and thorough resolution.
Review billing and coding for all current and new medical service lines for accuracy and consistency.
Document patient billing questions and concerns, subsequently inputting all detailed notes and records into the company database.
Prepare educational materials, training programs, and presentations to enhance understanding of the appeals and grievances process.
Coach junior colleagues on best practices and SOPs for handling complaints and appeals.
Assist with the training of junior-level staff to promote the development of departmental capabilities.
Perform other duties as needed.
Required Qualifications
1-2 years of experience in claims, data entry, and/or healthcare.
Must reside in Arizona.
Preferred Qualifications
Working knowledge of problem solving and decision-making skills.
Previous experience with DAG and QNXT.
Strong reading and writing skills, ensuring documents meet standards and are accurate.
Excellent organizational skills.
Experience in customer interactions and review of health-related materials.
Strong interpersonal skills.
Strict attention to detail.
Self-motivated and able to work independently.
Education
High school diploma or GED.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The Typical Pay Range For This Role Is
$21.10 - $40.90
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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We anticipate the application window for this opening will close on: 05/08/2026
#J-18808-Ljbffr
Position Summary
The Complaints & Appeals Intake Coordinator prepares information and reports needed to address matters regarding complaints, appeals, and grievances. This person carries out policies, procedures, and programs to ensure compliance with federal and/or state regulations.
What You Will Do
Review, interpret, and process appeals and grievances filed by patients, escalating more complex issues and concerns to management for review and follow-up.
Perform patient and insurance report analysis and identify any trends or issues that need to be addressed.
Conduct reviews of decisions and case files to determine if there are any errors or anomalies in the application of law or evidence.
Draft and send appeal decision letters, conducting detailed follow-up for timely and thorough resolution.
Review billing and coding for all current and new medical service lines for accuracy and consistency.
Document patient billing questions and concerns, subsequently inputting all detailed notes and records into the company database.
Prepare educational materials, training programs, and presentations to enhance understanding of the appeals and grievances process.
Coach junior colleagues on best practices and SOPs for handling complaints and appeals.
Assist with the training of junior-level staff to promote the development of departmental capabilities.
Perform other duties as needed.
Required Qualifications
1-2 years of experience in claims, data entry, and/or healthcare.
Must reside in Arizona.
Preferred Qualifications
Working knowledge of problem solving and decision-making skills.
Previous experience with DAG and QNXT.
Strong reading and writing skills, ensuring documents meet standards and are accurate.
Excellent organizational skills.
Experience in customer interactions and review of health-related materials.
Strong interpersonal skills.
Strict attention to detail.
Self-motivated and able to work independently.
Education
High school diploma or GED.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The Typical Pay Range For This Role Is
$21.10 - $40.90
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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We anticipate the application window for this opening will close on: 05/08/2026
#J-18808-Ljbffr