Inbound Outbound Queue Associate

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Shift Available: Monday - Friday, 12:00pm - 8:30pm EST

*Training: 10:00 AM - 6:30 PM ET, Monday-Friday, for first 8 weeks

*This department is open 365 days a year, some holidays may be required
 

Position Summary

Inbound Queue Associate - Behavioral Health role is responsible for accepting inbound calls from facilities, providers, and members regarding pre-certification process within Medicare and Commercial Insurance.

Responsibilities to include but limited to the following:

• Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
• Screens requests for appropriate referral to medical services staff.
• Approve services that do not require a medical review in accordance with the benefit plan.
• Performs non-medical research including eligibility verification, COB, and benefits verification.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Communicate with Aetna Case Managers, when processing transactions for members active in this program
• Other duties and responsibilities as required.

Required Qualifications

• 1+ years of Customer Service Background
• 1+ years of Call Center experience
• Must have high speed internet and a secure working space

Preferred Qualifications

• Familiarity with basic medical terminology and concepts used in care management.
• 2-4 years experience as a medical assistant, office assistant or other clinical experience.
• Effective communication, telephonic and organization skills.
• Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
• Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants

Education

• High School Diploma or equivalent GED

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.  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 people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.