Eligibility Consultant - Paper Ops, CVS Health

CVS Health

Location:
United States

Category:
Customer Service

Contract Type:
Not provided

Salary:

17.00 - 34.15 USD / Hour

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Job Description:

Enrollment Representative position supporting multiple health plans. Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns. Maintains enrollment databases and coordinates transfer of non-electronic eligibility data.

Job Responsibility:

Verifies enrollment status
Makes changes to member/client records
Addresses enrollment questions or concerns
Maintains enrollment databases
Coordinates transfer of non-electronic eligibility data
Researches and resolves eligibility and/or billing related issues
Works with clients, field marketing offices and local claim operations
Monitors daily status reports
Applies technical requirements, legislative/regulatory policies, account structure and benefit parameters
Validates benefit plan enrollment information
Coordinates distribution of membership ID cards
Completes screen coding and data entry
Reviews and corrects transaction errors
Interprets and translates client benefits
Determines and communicates standard service charges
Partners with other team functions

Requirements:

Attention to detail and accuracy
Problem solving skills
Strong organization skills
Understands the impact of work to other teams and downstream support areas
Ability to analyze and research data to make appropriate corrections as necessary
Strong verbal and written communication skills
Workplace flexibility - ability to adapt to change
Required to maintain work schedule within EST time zone (9:30am- 6:00pm EST)
Ability to remain available for overtime, with possible weekend work where needed
High School Diploma or equivalent

Nice to have:

Knowledge of Health Care and/or MCO's
Knowledge of DSNP
Knowledge of Enrollment
Knowledge Medicaid and/or Medicare
Knowledge and comfortability with learning different systems and using Excel (VLOOKUP)

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation programs
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

Additional Information:

Job Posted:
August 24, 2025

Expiration:
September 05, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Eligibility Consultant - Paper Ops