Benefits Verification Representative

Employment Type: Full time

Location Type: Work From Home (Onsite requirements for IT/Technical issues, performance reviews, etc.)

Position Overview

CVS Health/Specialty is seeking a Benefits Verification Representative to join our team. This role is crucial in connecting patients, healthcare professionals, and insurance carriers to resolve insurance-related issues and ensure timely processing of prescription orders. You will be a key player in transforming healthcare by providing connected, convenient, and compassionate care.

Responsibilities

• Serve as a critical liaison between patients, healthcare professionals, and insurance carriers.
• Utilize skills and healthcare industry expertise to efficiently solve insurance-related issues.
• Process patient prescription orders for on-time delivery.
• Work with multiple systems and portals.
• Handle inbound patient and internal colleague calls.
• Make outbound calls on a daily basis.

Requirements

• 1+ years of experience in a healthcare environment, with experience in medical insurance, benefits verification, medical billing, or a related field.
• 1+ years of work experience with Windows-based applications such as Microsoft Office (Outlook, Excel, Teams, Word), internet navigation, and email applications.
• 1+ years of computer keyboarding experience, skills, and aptitude.
• Must have a direct/hardwired internet connection to a modem/router within 7 feet of your computer.
• Minimum internet speed requirement: 25 Mbps download and 3 Mbps upload. (WiFi and satellite are not permitted).
• A secure and private home workspace free from distractions is required.

Preferred Qualifications

• Pharmacy or Healthcare Benefits experience.
• Previous experience working with Prior Authorizations.
• Experience with various insurance plans (PPO, HMO, EPO, POS, Medicare, Medicaid, HRA’s) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.
• Experience reading and understanding medical policy information.
• Experience utilizing insurance benefit and coverage information to calculate estimated patient responsibility.
• Experience making inbound and outbound calls to patients to explain insurance benefits and discuss patient financial responsibilities.
• Knowledge of Avaya-One X, Availity, Change HealthCare, and/or CoverMyMed.

Company Information

At CVS Health, we are building a world of health around every consumer. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels, and over 300,000 purpose-driven colleagues. We are committed to caring for people where, when, and how they choose, in a uniquely connected, convenient, and compassionate way. We do it all with heart, each and every day.

Benefits

• Comprehensive benefits package including medical, dental, and vision insurance.
• Wide-ranging supplemental benefits and discount programs.
• Sixteen paid days off.
• Ten paid holidays.
• Overtime opportunities during business peaks.

Application Instructions

1. Apply online.
2. Complete our Virtual Job Tryout (VJT).