IME Customer Service Representative
Blank StreetSalary not specified
Full Time
Entry Level & New Grad, Junior (1 to 2 years)
Not SpecifiedCompensation
Entry Level & New GradExperience Level
Full TimeJob Type
UnknownVisa
Healthcare, InsuranceIndustries
Requirements
Candidates should have 1-2 years of experience as a medical assistant, office assistant, or in another clinical/equivalent role. An Associate's degree is preferred, but a High School Diploma, GED, or equivalent experience is acceptable. Call center and prior authorization experience, each for 1-2 years, are also preferred.
Responsibilities
The Inbound/Outbound Queue Associate will coordinate medical services, including intake, screening, and referrals, by performing intake of calls, utilizing Aetna systems to manage member information, and screening requests for appropriate referrals. Responsibilities include approving services that do not require medical review, performing non-medical research, and maintaining accurate documentation to meet regulatory requirements. The role also involves promoting communication with internal and external parties, protecting member confidentiality, supporting the precertification process, and placing outbound calls to providers for information gathering. This position requires sedentary work with significant computer use and visual acuity.
Skills
Medical Services Coordination
Intake
Screening
Referrals
Call Center
Data Entry
Eligibility Verification
Benefits Verification
Documentation
Confidentiality
Communication
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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