Experienced Benefits Verification Representative - Remote Work Opportunity in Healthcare Insurance and Patient Services

Introduction to CVS Health and Our Mission

At CVS Health, we are driven by a clear purpose: to bring our heart to every moment of your health. This purpose is the foundation of our commitment to delivering enhanced, human-centric healthcare for a rapidly changing world. Our brand, with heart at its center, sends a personal message that how we deliver our services is just as important as what we deliver. We are looking for a skilled and compassionate Benefits Verification Representative to join our team, working remotely with occasional on-site training and collaboration.

About the Role

As a Benefits Verification Representative, you will be a critical liaison between our patients, healthcare professionals, and insurance carriers. Your primary responsibility will be to efficiently solve insurance-related issues to process patient prescription orders for on-time delivery. This role requires excellent computer navigation skills, strong interpersonal skills, attention to detail, and a solution-oriented mindset. You will work in multiple systems and portals, handle inbound patient and internal colleague calls, and make outbound calls on a daily basis.

Key Responsibilities:

• Utilize healthcare industry expertise to verify benefits and resolve insurance-related issues for patients.
• Work in multiple systems and portals to process patient prescription orders efficiently.
• Handle inbound patient and internal colleague calls, and make outbound calls to resolve issues and provide excellent customer service.
• Embodify our Heart At Work Behaviors, putting people first and delivering personalized patient experiences.
• Collaborate with cross-functional teams to ensure seamless delivery of healthcare services.

Essential Qualifications

To be successful in this role, you will need:

• 1+ years of experience in a healthcare environment, with experience working with medical insurance, benefits verification, medical billing, or a related field.
• 1+ years of work experience with Windows-based applications like Microsoft Office (Outlook, Excel, Teams, Word), internet navigation, and email applications.
• 1+ years of computer keyboarding experience, skills, and aptitude.
• A direct/hardwired internet connection to a modem/router within 10 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload.
• A secure and private home workspace free from distractions.
• Must live within 75 miles of Monroeville, PA, for occasional on-site training and collaboration.

Preferred Qualifications

While not required, the following qualifications are preferred:

• Pharmacy or Healthcare Benefits experience.
• Previous experience working with Prior Authorizations.
• Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA’s) and coordination of healthcare benefits.
• Experience with reading and understanding medical policy information, and utilizing insurance benefit and coverage information to calculate estimated patient responsibility.
• Experience receiving inbound calls and making outbound calls to patients to explain insurance benefits related to health insurance, and/or discussing patient financial responsibilities.
• Knowledge of using Avaya-One X, Availity, Change HealthCare, and/or CoverMyMeds.

Education and Pay Range

A High School Diploma or equivalent work experience is required. The typical pay range for this role is $17.00 - $28.45 per hour, depending on experience and location.

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to the growth and development of our colleagues. As a Benefits Verification Representative, you will have access to numerous training and development opportunities, including:

• Comprehensive onboarding program, including 4 weeks of on-site training.
• Ongoing training and development programs to enhance your skills and knowledge.
• Opportunities for career advancement and professional growth.
• Access to free development courses and education assistance programs.

Work Environment and Company Culture

Our company culture is built on our Heart At Work Behaviors, which include:

• Putting people first and delivering personalized patient experiences.
• Embodying a solution-oriented mindset and rising to the challenge to help our patients.
• Collaborating with cross-functional teams to ensure seamless delivery of healthcare services.
• Embracing a goal-driven work ethic and striving for excellence in everything we do.

Compensation, Perks, and Benefits

In addition to a competitive salary, we offer a comprehensive benefits package, including:

• Medical, dental, and vision insurance.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Fully-paid term life insurance plan and short-term and long-term disability benefits.
• Paid Time Off (PTO) and paid holidays throughout the calendar year.
• CVS store discount and discount programs with participating partners.
• Numerous well-being programs and education assistance programs.

Conclusion

If you are a motivated and compassionate individual with a passion for delivering exceptional patient experiences, we encourage you to apply for this exciting opportunity. As a Benefits Verification Representative, you will play a critical role in our team, working remotely with occasional on-site training and collaboration. Don’t miss out on this chance to join our team and start your future with CVS Health. Apply now!