Inbound Outbound Que Associate, CVS Health

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:

Supports comprehensive coordination of medical services including intake, screening, and referrals to Aetna Better Health. Promotes/supports quality effectiveness of Healthcare Services. Performs intake of calls from members or providers regarding services via telephone, fax, EDI. Utilizes Aetna system to build, research and enter member information.

Job Responsibility:

Supports comprehensive coordination of medical services including intake, screening, and referrals to Aetna Better Health
Performs intake of calls from members or providers regarding services via telephone, fax, EDI
Utilizes Aetna system to build, research and enter member information
Screens requests for appropriate referral from medical services staff
Approve services that do not require a medical review in accordance with the benefit plan
Performs non-medical research including eligibility verification, COB, and benefits verification
Maintains accurate and complete documentation of required information
Promotes communication, both internally and externally to enhance effectiveness of medical management services
Protects the confidentiality of member information
Communicate with Aetna Case Managers when processing transactions for members active in this Program
Supports the administration of the precertification process
Places outbound calls to providers to provide information or obtain clinical information for approval of medical authorizations
Uses Aetna Systems such as MedCompass, QNXT, ProFAX and ProPAT
Communicates with Aetna Nurses and Medical Directors when processing transactions for members active in this Program

Requirements:

1-2 years' experience working as a medical assistant, office assistant or other clinical/equivalent experience
Associates degree preferred
High School Diploma, GED or equivalent experience

Nice to have:

Call center experience 1-2 years
Prior authorization experience 1-2 years

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
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:
November 21, 2025

Expiration:
November 27, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Inbound Outbound Que Associate