[Remote] Benefits Verification Specialist- Work from home at CVS Health

Georgia, Vermont, United States

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Not SpecifiedCompensation

Entry Level & New Grad, Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Pharmaceuticals, Home InfusionIndustries

Requirements

Candidates must possess a verifiable High School Diploma or GED and have a minimum of 1 year of experience in a customer service or call center environment. Experience with data entry and working knowledge of Microsoft Office, specifically Outlook and Word, are required. Preferred qualifications include experience in home infusion or durable medical equipment (DME), healthcare environments, verifying benefits with insurance companies, and working with healthcare insurance.

Responsibilities

The Benefits Verification Specialist will verify insurance coverage and obtain prior authorization information for patients to process prescription orders in a timely manner. Responsibilities include completing and documenting benefit verification reviews, providing information on Enteral home infusion services, and coordinating with Patient Intake Coordinators. The specialist will investigate insurance coverage to assess patient eligibility, communicate with medical professionals and insurance companies, and enter data into ACIS for accurate reporting. They will also provide input on self-reviews, assist less experienced peers, and perform other assigned duties.

Skills

Benefit Verification

Insurance Coverage

Prior Authorization

Customer Service

Pharmacy Benefits

Major Medical Benefits

Patient Assistance Programs

Regulatory Compliance

Healthcare

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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