Eligibility Consultant, CVS Health

CVS Health

Location:
United States, East Lansing

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 31.30 USD / Hour

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Job Description:

Eligibility Consultant position at CVS Health focused on verifying enrollment status, maintaining enrollment databases, resolving eligibility issues, and ensuring compliance with legislative/regulatory policies while providing excellent customer service.

Job Responsibility:

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 electronic transfer of eligibility data
Responds, researches, and resolves eligibility and other enrollment related issues involving member specific information
Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters
Develops tools, and provides coding supplements, tape specifications and error listing to clients/vendors
Acts as the liaison between clients, vendors, and the IT department with defining business requirements
Ensures all transactions interface accordingly with downstream systems
Partners with other team functions to coordinate the release of eligibility, plan structure and benefit information
Completes required set-up of policy and eligibility screens
Codes system screens, policy, and structure to support downstream processes
Ensures that legislation and compliance has been properly adhered to
Determines and communicates standard service charges to internal/external customers
Ensures all communications with clients adhere to HIPAA compliance requirements

Requirements:

1+ years of excellent customer service skills with the ability to communicate effectively with both internal and external customers
1+ years of Data entry experience
Must be able to type at least 35WPM
Excellent verbal and written communication skills including articulation, spelling, grammar, proofreading, and telephone skills
Experience with Word and proficient in Excel
High School diploma or G.E.D.

Nice to have:

Basic knowledge of Health Insurance industry
6 months of more experience with QuickBase

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and 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 01, 2025

Expiration:
October 03, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Eligibility Consultant