Eligibility Consultant - Electronic Remote Customer Service Representative with Benefits and Growth Opportunities

Join the CVS Health Team as an Eligibility Consultant - Electronic

CVS Health is a leading healthcare company that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world. Our purpose is to bring our heart to every moment of your health, and we achieve this through our commitment to providing personalized, convenient, and affordable healthcare solutions. We are seeking a highly skilled and motivated Eligibility Consultant - Electronic to join our team on a remote basis. As an Eligibility Consultant, you will play a critical role in verifying enrollment status, making changes to member/client records, and addressing a variety of enrollment questions or concerns.

About CVS Health

At CVS Health, we are passionate about delivering healthcare services that are centered around the needs of our customers. Our company culture is built on a foundation of respect, integrity, and compassion, and we strive to create a work environment that is engaging, challenging, and rewarding for our employees. Our Heart At Work Behaviors program supports our purpose and encourages our employees to embody the values of CVS Health in everything they do.

Job Summary

As an Eligibility Consultant - Electronic, you will be responsible for verifying enrollment status, making changes to member/client records, and addressing a variety of enrollment questions or concerns. You will also maintain enrollment databases, coordinate the transfer of eligibility data, and utilize online resources to understand account structure and benefits. Your goal will be to provide exceptional customer service and resolve eligibility and other enrollment-related issues in a timely and efficient manner.

Key Responsibilities:

• Verify enrollment status, make changes to member/client records, and address a variety of enrollment questions or concerns
• Maintain enrollment databases and coordinate the transfer of eligibility data
• Utilize and interpret online resources to understand account structure and benefits, and may assist with the development of such resources
• Respond, research, and resolve eligibility and other enrollment-related issues involving member-specific information by working directly with clients, vendors, and internal partners
• Apply all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure, and benefit parameters in addressing eligibility matters
• Act as the liaison between clients, vendors, and the IT department, defining and identifying business requirements and solutions for non-standard arrangements
• Ensure all transactions interface accordingly with downstream systems; test and validate data files for new or existing clients using system tools and track results to avoid potential problems and better address on-going service issues
• Partner with other team functions to coordinate the release of eligibility, plan structure, and benefit information
• Complete required set-up of policy and eligibility screens in order to activate system processing of plan benefits
• Code system screens, policy, and structure to support downstream processes and the generation and release of Member and Plan Sponsor products
• Ensure all communications with clients, third-party administrators, and/or brokers involving sensitive member data adhere to HIPAA compliance requirements

Requirements and Qualifications

Essential Qualifications:

• Excellent written and verbal communication skills, which demonstrate the ability to interact courteously and effectively with both internal and external customers
• Demonstrated ability to creatively solve problems and create improvements
• Experience with Word, Excel, Outlook
• Data entry experience
• Understands intent/end state and operates with minimal guidance to meet that intent/end state
• Ability to manage multiple tasks and shifting priorities
• Ability to manage high work volume and oversee a variety of incoming work flows
• A team player capable of operating independently when needed
• Deliver accurate and timely results
• Follows up as needed to effectively resolve an issue

Preferred Qualifications:

• Previous experience as an Eligibility Consultant or in a related field
• High School diploma, G.E.D., or equivalent experience

What We Offer

At CVS Health, we offer a comprehensive benefits package that includes:

• A competitive salary with a pay range of $17.00 - $31.30 per hour
• A full range of medical, dental, and vision benefits
• Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees
• A fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits
• Numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners
• Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year

Why Join CVS Health?

At CVS Health, we are committed to creating a work environment that is engaging, challenging, and rewarding for our employees. Our company culture is built on a foundation of respect, integrity, and compassion, and we strive to provide opportunities for growth and development. As an Eligibility Consultant - Electronic, you will have the opportunity to:

• Work with a talented team of professionals who are passionate about delivering exceptional customer service
• Develop your skills and expertise in a fast-paced and dynamic environment
• Contribute to the success of CVS Health and make a positive impact on the lives of our customers

How to Apply

If you are a motivated and customer-focused professional who is looking for a new challenge, we encourage you to apply for this exciting opportunity as an Eligibility Consultant - Electronic. Please submit your application, including your resume and cover letter, to be considered for this role.

CVS Health is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to providing a work environment that is free from harassment and discrimination, and where all employees are treated with dignity and respect.

Don't miss this opportunity to join our team and make a difference in the lives of our customers. Apply now and take the next step in your career!