Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

Shift Available: Monday-Friday; 11:00am-7:30pm EST
Holidays required.

This is a fully remote position and the following are some required Work from Home criteria which includes but is not limited to maintaining your own internet with approved speed requirements, secure workspace free from distractions, and successful completion of the training program. Download speed 25mbps or more and upload speed 10 mbps or more. Hard wiring into modem will be required. 

• Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
• Screens requests for appropriate referral to medical services staff.
• Approve services that do not require a medical review in accordance with the benefit plan.
• Performs non-medical research including eligibility verification, COB, and benefits verification.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Communicate with Aetna Case Managers, when processing transactions for members active in this program

Required Qualifications

• 1-3 years of Customer Service Background
• 1-3 years of Call Center experience.

Preferred Qualifications

• Familiarity with basic medical terminology and concepts

used in care management.

• 2-4 years experience as a medical assistant, office

assistant or other clinical experience.

• Effective communication, telephonic and organization

skills.

• Strong customer service skills to coordinate service

delivery including attention to customers, sensitivity to
issues, proactive identification and resolution of issues to
promote positive outcomes for members.

• Computer literacy in order to navigate through

internal/external computer systems, including Excel and
Microsoft Word.

• Ability to effectively participate in a multi-disciplinary

team including internal and external participants

Education

• High School Diploma or G.E.D., equivalent experience

Pay Range

The typical pay range for this role is:

$17.00 - $34.15

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/25/2024

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