Benefits Verification Representative, CVS Health

CVS Health

Location:
United States, Raleigh ▼
Monroeville

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 28.46 USD / Hour

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Job Description:

CVS Health/Specialty is offering an opportunity to join the Benefits Verification team primarily as a work-from-home position. Responsibilities include addressing insurance concerns related to patient prescription delivery, working in multiple systems, and handling phone calls. The role requires attention to detail, problem-solving abilities, and customer service skills.

Job Responsibility:

Serve as a liaison between patients, healthcare professionals, and insurance carriers
Solve insurance-related issues to process patient prescription orders for on-time delivery
Work in multiple systems and portals
Handle inbound patient and colleague calls
Make outbound calls.

Requirements:

Must live within 75 miles of Raleigh, NC or Monroeville, PA
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
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 (i.e., 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:

Affordable medical plan options
a 401(k) plan (including matching company contributions)
an employee stock purchase plan
No-cost wellness programs including screenings, tobacco cessation and 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:
June 02, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Benefits Verification Representative