Senior Eligibility Consultant - Remote

Overview

As a Senior Eligibility Consultant at CVS Health, you will play a crucial role in verifying enrollment statuses and addressing various eligibility concerns while ensuring compliance with regulations.

In Short

• Verify enrollment status and make changes to member/client records.
• Maintain enrollment databases and coordinate eligibility data transfers.
• Resolve eligibility issues by collaborating with clients and vendors.
• Develop tools and provide coding supplements for clients/vendors.
• Ensure compliance with HIPAA regulations in communications.
• Test and validate data files for new or existing clients.
• Utilize online resources to understand customer account structures.
• Manage multiple tasks effectively in a fast-paced environment.
• Communicate effectively with internal and external customers.
• Support team members and contribute to positive service outcomes.

Requirements

• 2+ years of experience in healthcare/insurance customer service.
• 2+ years of data entry experience.
• Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams).
• Previous eligibility data experience is preferred.
• Working knowledge of EDI files and 834 file layouts.
• Excellent verbal and written communication skills.
• Ability to manage high work volume and shifting priorities.
• Team player with independent working capability.
• Problem-solving skills and attention to detail.
• High School diploma or GED required.

Benefits

• Affordable medical plan options.
• 401(k) plan with company matching contributions.
• Employee stock purchase plan.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave options.
• Dependent care resources and colleague assistance programs.
• Retiree medical access and various other benefits.
• Comprehensive benefits to support employee wellness.
• Commitment to fostering a diverse workplace.