Eligibility Consultant, CVS Health

Eligibility Consultant

CVS Health

Location:
United States

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 34.15 USD / Hour

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Job Description:

Position supports multiple health plans, verifying member enrollment status, making demographic changes, addressing enrollment questions, and manually updating enrollment data. Applies technical requirements, legislative/regulatory policies, and benefit parameters to resolve eligibility matters.

Job Responsibility:

Verify member enrollment status
Make changes to member demographics, effective and term dates
Addresses enrollment questions or concerns from health plan/state
Manual QNXT updates on fall out edits from electronic enrollment files
Manually update urgent requests received via email
Work claim inquiries (H03s)
Manually enter temp newborns
Review and manually update reconciliation reports from Finance
Research and resolve eligibility related issues
Validate benefit plan enrollment information
Coordinate distribution of membership ID cards
Complete data entry for enrollment changes and terminations
Partner with other teams to coordinate release of eligibility information

Requirements:

Customer Service Experience Required
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
High school diploma or equivalent required

Nice to have:

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

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:
October 11, 2025

Expiration:
November 01, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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