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 Assists with processing, insurance verification and authorization, revenue cycle management, compliance, and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations. What you will do
Gathers necessary information to verify critical member benefits insurance coverage, such as policy numbers, group numbers, and demographic details.
Reviews insurance plans and policies to determine the extent of coverage for different medical procedures, treatments, medications, or services.
Contacts insurance providers to verify eligibility, coverage limits, pre-authorization requirements, and any specific benefits relevant to member services or treatments.
Explains the verification process, provides updates on the status of benefits verification, and addresses any questions or concerns related to coverage or financial responsibility.
Maintains accurate and detailed records of insurance verification activities, including documenting conversations, collecting insurance information, and updating patient or member profiles.
Communicates any authorization requirements, coverage limitations, or pre-certification processes to ensure smooth billing and claims processing.
Investigates and resolves any challenges or conflicts that may arise during the verification process, working closely with insurance providers, patients, or members to find resolutions.
Proposes process enhancements, automation, or system improvements to streamline operations and enhance the overall effectiveness of benefits verification activities.
Responds to member inquiries and concerns promptly, empathetically, and professionally, ensuring a positive customer experience.
Required Qualifications
1 year work experience
Preferred Qualifications
Certified Professional, Life and Health Insurance Program (CPLHI) preferred.
Certified Employee Benefit Specialist (CEBS) preferred.
Education
High School Diploma
Pay RangeThe typical pay range for this role is:$17.00 - $28.45This 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 jobs.CVSHealth.com/benefits We anticipate the application window for this opening will close on: 05/07/2024We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
