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CVS Health Benefits Verification Specialist - Remote in Pittsburgh, Pennsylvania

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

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 this person will be required to come onsite for a 4-week new hire training. Training in-person 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.

On Site Training is Monday through Fridays 8:00am - 4:30pm EST for 4 weeks.

We are seeking individuals to commit to a 40-hour work week. We are offering shifts Monday through Friday with start times ranging from 9:00am - 11:00am EST.

Our application process is 2 simple steps.

  • Apply online.

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

    Compensation:

    This position pays based on experience and the starting hourly rate for this role is $17.50/hr. Starting pay rates are based on experience, ranging from: $17.50 - $19.00

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 10 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.

Pay Range

The typical pay range for this role is:

$17.00 - $28.45

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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers 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. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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