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.Position Summary
Assists with insurance verification and authorization, revenue cycle management, copay assistance and issue resolution and follow up. Provides support to referral sources and pharmacy team to ensure timely processing of referrals.Gathers necessary information to verify critical member benefits insurance coverage, such as policy numbers, group numbers, and demographic detailsReviews insurance plans and policies to determine the extent of coverage.Contacts insurance providers to verify eligibility, coverage limits, pre-authorization requirements, and any specific benefits relevant to member services or treatmentsExplains the verification process, provides updates on the status of benefits verification, and addresses any questions or concerns related to coverage or financial responsibilityCommunicates any authorization requirements, coverage limitations, or pre-certification processes to ensure smooth billing and claims processingInvestigates and resolves any challenges or conflicts that may arise during the verification process, working closely with insurance providers, patients, or members to find resolutionsProposes process enhancements, automation, or system improvements to streamline operations and enhance the overall effectiveness of benefits verification activities.Works with pharmacy team to provide promptly and professionally, ensuring a positive customer experience.Required Qualifications
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At least 1 year work experience.Preferred Qualifications
Specialty Pharmacy experience
Education
High School diploma Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$17.00 - $25.65This 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.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 peopleWe 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.