Benefits Verification Specialist

Benefit Verification Specialist

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

For this position, candidates must live within a commutable distance to one of the following locations (within 60 minutes):

• Malvern, PA (6 Spring Mill Drive)
• Mendota Heights, MN (2345 Waters Drive)
• San Diego, CA (12310 World Trade Drive)

Shift: M-F 8:30am - 5pm CST or 9am - 5:30pm CST

Position Summary: Coram/CVS Health is looking for a high-energy healthcare professional to join our National team as Benefit Verification Specialist! This rewarding opportunity allows you to work closely with our Patient Intake Coordinators and insurance providers to verify coverage for in-home Specialty therapies for Coram's patients. We believe that Benefit Verification Specialists are a key part of creating a positive experience for our patients.

In this dynamic and fast-paced role, you will be responsible to verify insurance coverage and obtain prior authorization information for both new and existing patients in order to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. This role will require an understanding of insurance carriers and concepts including pharmacy benefits, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.

Key Responsibilities:

• Complete and document benefit verification review
• Provides information on specialty medications/ home infusion services.
• Comply with and adhere to all regulatory compliance areas, policies, and procedures, and "best practices."
• Coordinate with the Patient Intake Coordinators for new and existing accounts.
• Investigate type and level of insurance coverage to assess patient eligibility for the program.
• Communicate with medical professionals and insurance company personnel.
• Complete data enter in ACIS to ensure accuracy of reporting and outcomes.
• Provide input on self reviews
• Assist less experienced peers
• Perform other duties & responsibilities that are reasonable as assigned by your leaders

Required Qualifications:

• Experience verifying benefits with insurance companies
• Data entry experience.
• Working knowledge in Microsoft Office, specifically Outlook and Word.

Preferred Qualifications:

• Home infusion or durable medical equipment (DME) experience.
• Experience work in a healthcare environment.
• Experience working with healthcare ins

Education: Verifiable High School diploma or GED is required

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: The typical pay range for this role is:

$17.00 - $31.30

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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.