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CVS Health Logo CVS Health · Customer Service

Benefits Verification Representative

United States, Raleigh Employment contract 17.00 - 28.46 USD / Hour · Job Posted June 02, 2025
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Job Description

CVS Health/Specialty is offering an opportunity to join the Benefits Verification team primarily as a work-from-home position. Responsibilities include addressing insurance concerns related to patient prescription delivery, working in multiple systems, and handling phone calls. The role requires attention to detail, problem-solving abilities, and customer service skills.

Job Responsibility

  • Serve as a liaison between patients, healthcare professionals, and insurance carriers
  • Solve insurance-related issues to process patient prescription orders for on-time delivery
  • Work in multiple systems and portals
  • Handle inbound patient and colleague calls
  • Make outbound calls.

Requirements

  • Must live within 75 miles of Raleigh, NC or 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
  • direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload
  • a secure and private home workspace free from distractions is required.

Nice to have

  • 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.

What we offer

  • Affordable medical plan options
  • a 401(k) plan (including matching company contributions)
  • an employee stock purchase plan
  • No-cost wellness programs including screenings, tobacco cessation and weight management programs, confidential counseling, financial coaching
  • Paid time off
  • flexible work schedules
  • family leave
  • dependent care resources
  • colleague assistance programs
  • tuition assistance
  • retiree medical access.
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