Benefits Verification Representative - Monroeville, PA

Benefits Verification Representative

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

CVS Health/Specialty is offering an exciting opportunity to be part of our Benefits Verification team. This is primarily a WORK FROM HOME position. However, candidates must live within a 75-mile commutable distance from Monroeville, PA because you may also be asked to come into the office for Training, IT/Technical issues, Performance Review/Evaluation, etc. Training allows our new team members to familiarize themselves with members of training, support, leadership, and their new peers to ensure a successful and team-focused onboarding experience.

As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals and insurance carriers. You will utilize your skills and healthcare industry expertise to efficiently solve insurance-related issues to process patient prescription orders for on-time delivery. In this role, you will work in multiple systems and portals, and handle inbound patient and internal colleague calls, as well as make outbound calls on a daily basis. Successful candidates in this role will embody our heart at work behaviors and possess:

• Excellent computer navigation skills.
• Interpersonal skills to put people first and deliver personalized patient experiences.
• Strong attention to detail.
• A solution orientated mindset removing obstacles to make experiences easier and rising to the challenge to help our patients.
• A goal-driven work ethic.

This position is full-time and offers overtime during our business peaks. We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.

Our application process is 2 simple steps.

- Apply online.

- Take your time while completing our Virtual Job Tryout (VJT)

Required Qualifications

- Must live within 75 miles of Monroeville, PA.

- 1+ years of experience in 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.

- You must have a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs 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 offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA's) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.

- Experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to calculate estimated patient responsibility, taking into consideration pre-determination, referral, authorization, and contract terms.

- 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 with using Avaya-One X, Availity, Change HealthCare and/or CoverMyMeds.

Education

- High School Diploma or equivalent work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $17.00 - $28.46. This 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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.