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Benefits Verification Representative

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States, Mount Prospect

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Category:
Customer Service

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Contract Type:
Employment contract

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Salary:

17.00 - 31.30 USD / Hour

Job Description:

CVS Health is offering an opportunity to join its Benefits Verification team as a Benefits Verification Representative. This primarily work-from-home role involves working with patients, healthcare professionals, and insurance carriers to resolve insurance issues and process prescription orders. Candidates must live within 75 miles of Mount Prospect, IL for required onsite training and occasional office visits.

Job Responsibility:

  • Act as a liaison between patients, healthcare professionals, and insurance carriers
  • Utilize skills and healthcare expertise to resolve insurance-related issues and process patient prescription orders
  • Work in multiple systems and portals to handle inbound and outbound calls
  • Deliver personalized patient experiences
  • Remove obstacles and provide solutions for patient needs.

Requirements:

  • Must live within 75 miles of Mount Prospect, IL
  • 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 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 (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:
  • Medical, dental, vision insurance
  • 401(k) plan including matching company contributions
  • Employee stock purchase plan
  • No-cost wellness programs, including wellness screenings, tobacco cessation, and weight management
  • Confidential counseling and financial coaching
  • Paid time off
  • Ten paid holidays
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Tuition assistance
  • Retiree medical access.

Additional Information:

Job Posted:
June 01, 2025

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:
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