Advanced Eligibility Consultant, CVS Health

CVS Health

Location:
United States, Lansing, MI or Plymouth, MN

Category:
Customer Service

Contract Type:
Not provided

Salary:

43888.00 - 93574.00 USD / Year

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Job Description:

The Advanced Eligibility Consultant is responsible for our most complex and highest valued clients. The Advanced Eligibility Consultant will also work and resolve complex issues. They translate direction and intent into actionable items while operating with minimal supervision. This person is consultative in nature when working with other departments, clients, and brokers. They coach and mentor junior staff, develop and execute training plans, coordinate and set daily objectives, identify and implement process improvements and efficiencies, and function as our highest level of escalation prior to manager/director involvement.

Job Responsibility:

Translate direction and intent into actionable items while operating with minimal supervision
Consultative in nature when working with other departments, clients, and brokers
Coach and mentor junior staff, develop and execute training plans, coordinate and set daily objectives, identify and implement process improvements and efficiencies, and function as our highest level of escalation prior to manager/director involvement
Establish and maintain processes regarding billing and claims processing, insurance verification and authorization, revenue cycle management, and compliance & documentation, as well as customer service and issue resolution
Reconcile and solve issues to ensure accurate billing, facilitate smooth revenue flow, maintain compliance, and provide satisfactory customer experiences

Requirements:

2+ years of experience with eligibility, particularly within the commercial health insurance industry, including a demonstrated proficiency in processing accurate and timely policy and eligibility data, ensuring services and products meet the plan sponsor needs
Must reside in Lansing, MI or Plymouth, MN
Ability to work a hybrid schedule (3 days in the office per week)
Bachelor’s degree or equivalent experience (high school diploma or GED + 4 years of relevant experience)

Nice to have:

Ability to manage multiple tasks/priorities
Understands intent/end state and operates with minimal guidance to meet that intent/end state
Team player capable of operating independently when needed
Ability to provide accurate and timely results
Ability to delegate and follow up as needed
Ability to coach and mentor others
Experience as a Senior Eligibility Consultant and/or Senior Eligibility Analyst

What we offer:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including 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

Additional Information:

Job Posted:
May 02, 2025

Expiration:
May 12, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Advanced Eligibility Consultant