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CVS Health

Bringing our heart to every moment of your health.

Eligibility Consultant – Paper Operations

OperationsOperationsOtherRemoteSeniorTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

Pennsylvania

Posted

124 days ago

Salary

$17 - $28 / hour

Seniority

Senior

High SchoolEnglish

Job Description

Eligibility Consultant – Paper Operations

CVS Health

• Verify member enrollment status • Make changes to member – demographics, effective and term dates • Addresses a variety of enrollment questions or concerns from the health plan / state • Manual QNXT updates on all fall out edits from the daily, weekly, monthly, quarterly electronic enrollment files • Manually update urgent request received via email from the health plan / state • Work claim inquiries (H03s) • Manually enter temp newborns • Review and manually update all reconciliation reports received from Finance • Responds, researches, and resolves eligibility related issues involving member specific information • Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization. • Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations. • Partners with other team functions to coordinate the release of eligibility and benefit plan information.

Job Requirements

  • Customer Service experience.
  • Attention to detail and accuracy.
  • Problem solving skills.
  • Strong organization skills.
  • Understands the impact of work to other teams and downstream support areas.
  • Ability to analyze and research data to make appropriate corrections as necessary.
  • Strong verbal and written communication skills.
  • Workplace flexibility - ability to adapt to change.
  • Knowledge of Health Care and/or MCO’s (preferred).
  • Knowledge of Enrollment (preferred).
  • Knowledge Medicaid and/or Medicare (preferred).

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • 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.

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