HI, MI, NC, PA, CA, AZ, KS, FL, IL, TN NYC, TX also fully Remote Pay starts are $17.00
Our team of nearly 50,000 employees serves an estimated 37 million people and is committed to giving them a better health care experience while providing access to affordable, high-quality health care. Our digital tools and online resources help guide members on their health care journey. And our people are empowered, innovative, and supported at every step of their own career journey. Read employee reviews here
WORK FROM HOME-Chicago IL
As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals, and insurance carriers. You will verify insurance coverage in order to process patient prescription orders in a timely manner. Successful candidates in this role will possess an empathetic telephone presence, strong attention to detail, problem-solving skills, and a goal-driven work ethic. This position is 40 hours and offers overtime during our business peaks.
We are seeking individuals open to working 40 hours a week, Monday through Friday, anytime between 7:30 am – 7:30 pm. You must be flexible working an early or late shift. However, a shift will be given to you and you will not be expected to rotate shifts daily. Our application process is 2 simple steps. – Apply online – Take your time while completing our Virtual Job Tryout (VJT).
Required Qualifications – 1+ years experience in a healthcare environment, with direct experience interpreting health insurance coverage and acting as a liaison relaying the coverage approvals and denials. – Proficient work experience with Microsoft Office, internet navigation, and email applications.
WORK FROM HOME-Chicago IL
At times you will also be responsible for answering patient calls to coordinate and process new patient medication orders and reorders, which includes verifying and re-verifying benefits Successful candidates will have superb communication skills and excellent data entry skills. If you like working in a fast-paced environment and demonstrating compassionate, genuine care for patients and customers, this job is for you! We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays. Our application process is 2 simple steps: 1. Apply online 2. Take our Online Virtual Job Tryout (Interview Platform) to learn even more about the position
Required Qualifications • Six months experience in a pharmacy • Six months work experience with Windows-based applications like Windows, Microsoft Office, internet navigation, and email applications • Six months computer keyboarding skills and aptitude • Active state of Illinois Pharmacy Technician License
This is a work-from-home position for candidates in any US location.
Enrollment and Billing is the important first line of contact with customers, setting the tone for how members view our company. It provides members with the right information at the right time to help them make better decisions about their health and health care.
Process accurate and timely eligibility into Aetna Systems utilizing Aetna policy guidelines and in accordance with key performance measures.
-Provide IVL Exchange membership with accurate bills and members with timely and accurate ID cards and audit cert lists.
-Improvement of financial results by reducing losses associated with non-payment.
-Ensures collected reconciled dollars are allocated across benefits and structure.
-Responsible for servicing customers by processing enrollments account receivable inquiries in an accurate and timely manner.
-Develop and enhance customer relationships and assists others to accomplish the same by responding to customer inquiries to resolve customer concerns accurately and timely.
-Strives to exceed customer expectations via all communications.
-Must adhere to HIPPA compliance requirements.
Required Qualifications
-Minimum of one year recent and related Contact Center customer service or enrollment, accounts receivable.
-Experience in providing/accepting constructive feedback and serving as a training resource, mentor, and coach
-Experience with a Windows-based pc environment and in utilizing common office applications, including Outlook, MS Word, Excel, and PowerPoint.
-Experience with MEA, ASD, Oracle, Salesforce, and HRP
-Experience with 834EDI desired but not required
Work From Home Must live in the state of Michigan
We offer Work from Home flexibility if you meet standards. Work from Home qualifications includes but are not limited to maintaining your own internet with approved speed requirements and a secure workspace free from distractions. Adherence to HIPAA and governmental compliance is required in this role. Schedule options are designed to create a flexible work schedule for those balancing priorities in and outside of work. Days off and hours may vary, though you will have a set schedule. We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide range of full-time supplemental benefits and discount programs. We offer a complete PTO package for full-time colleagues including 10 paid company holidays. Our application process is 2 simple steps. 1. Apply online. 2. Take our Virtual Job Tryout to fast-track the recruitment process and start your career with CVS!
Required Qualifications • 1+ years of Customer Service experience handling and resolving customer needs over the phone • 6+ months of high-volume customer service experience working in Windows, Microsoft, or another similar application • Comfortable relating to customers in a patient and empathetic way that demonstrates a genuine concern for improving their quality of life
WORK FROM HOME-Pittsburgh, PA
As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals, and insurance carriers. You will verify insurance coverage in order to process patient prescription orders in a timely manner. Successful candidates in this role will possess an empathetic telephone presence, strong attention to detail, problem-solving skills, and a goal-driven work ethic. This position is 40 hours and offers overtime during our business peaks.
Required Qualifications
• One year experience in a healthcare environment, with direct experience interpreting health insurance coverage and acting as a liaison relaying the coverage approvals and denials.
• Proficient work experience with Microsoft Office, internet navigation, and email applications.
Preferred Qualifications · Pharmacy experience · Previous experience working with Prior Authorizations · Knowledge of Medicare, Medicaid, and third-party vendor
Education High School diploma or equivalent.
WORK FROM HOME-Phoenix, AZ
WORK FROM HOME
As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals, and insurance carriers. You will verify insurance coverage in order to process patient prescription orders in a timely manner. Successful candidates in this role will possess an empathetic telephone presence, strong attention to detail, problem-solving skills, and a goal-driven work ethic. This position is 40 hours and offers overtime during our business peaks.
Required Qualifications
• One year experience in a healthcare environment, with direct experience interpreting health insurance coverage and acting as a liaison relaying the coverage approvals and denials.
• Proficient work experience with Microsoft Office, internet navigation, and email applications.
Preferred Qualifications · Pharmacy experience · Previous experience working with Prior Authorizations · Knowledge of Medicare, Medicaid, and third-party vendor
Education High School diploma or equivalent.
WORK FROM HOME-Tallahassee, FL
As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals, and insurance carriers. You will verify insurance coverage in order to process patient prescription orders in a timely manner. Successful candidates in this role will possess an empathetic telephone presence, strong attention to detail, problem-solving skills, and a goal-driven work ethic.
This position is 40 hours and offers overtime during our business peaks. We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays. Our application process is 2 simple steps. Apply online and take your time while completing our Virtual Job Tryout.
Required Qualifications • One year experience in the healthcare environment, with direct experience interpreting health insurance coverage and acting as a liaison relaying the coverage approvals and denials. • Proficient work experience with Microsoft Office, internet navigation, and email applications.
WORK FROM HOME KANSAS
ob Description
The CVS Health Specialty Pharmacy is building an Inbound Pharmacy Service team to support our specialty patients who are in need of life-sustaining medications. We are hiring Customer Service Representatives to work in our inbound call center to make the connection and ensure timely delivery to those patients reaching out. life-sustaining
Our pharmacy has a high-energy culture and is passionate about providing excellent customer service with empathy while resolving the patients’ questions on the first call. If you get satisfaction by knowing that you have helped someone, apply today. Do you have at least 12 months of customer service experience working with customers/patients (in a fast-paced, metric environment)? Do you have strong computer skills and a passion for helping others? CVS provides the training and knowledge to set you up for success. We also offer incredible advancement opportunities so you can grow within the pharmacy or move to another role within CVS Health. If you take care of our patients, we will take care of your career. Our application process is 2 simple steps. 1. Apply online. 2. Take our Virtual Job Tryout to fast-track the recruitment process and start your career with CVS!
Required Qualifications • One year of Customer Service experience • Six months of high volume customer service experience working in Windows, Microsoft, or another application.
WORK FROM HOME-Phoenix, AZ
As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals, and insurance carriers. You will verify insurance coverage in order to process patient prescription orders in a timely manner. Successful candidates in this role will possess an empathetic telephone presence, strong attention to detail, problem-solving skills, and a goal-driven work ethic. This position is 40 hours and offers overtime during our business peaks. We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays. Our application process is 2 simple steps. Apply online and take your time while completing our Virtual Job Tryout.
Required Qualifications • One year experience in the healthcare environment, with direct experience interpreting health insurance coverage and acting as a liaison relaying the coverage approvals and denials. • Proficient work experience with Microsoft Office, internet navigation, and email applications.
Sacramento, CA
As a Benefits Verification Representative, you are a critical liaison between our patients, healthcare professionals, and insurance carriers. You will verify insurance coverage in order to process patient prescription orders in a timely manner. Successful candidates in this role will possess an empathetic telephone presence, strong attention to detail, problem-solving skills, and a goal-driven work ethic. This position is full-time/40 hours and offers overtime during our business peaks. Our hours of operation are from 5:30 am to 6:00 pm. Shifts can vary anytime in between those hours. You must be open to working anytime in between these hours to be qualified. The training period will last 4 weeks and the training times will be Monday through Friday 6:30 am-3:00 pm (PST). We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays. Our application process is 2 simple steps: – Apply online. – Take your time while completing our Virtual Job Tryout (VJT).
Required Qualifications – One year experience in a healthcare environment, with direct experience interpreting health insurance coverage and acting as a liaison relaying the coverage approvals and denials. – Proficient work experience with Microsoft Office, internet navigation, and email applications
Work from Home in PA!
We offer Work from Home flexibility if you meet standards. Work from Home qualifications includes but are not limited to maintaining your own internet with approved speed requirements and a secure workspace free from distractions. Adherence to HIPAA and governmental compliance is required in this role. Schedule options are designed to create a flexible work schedule for those balancing priorities in and outside of work. Days off and hours may vary, though you will have a set schedule. We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide range of supplemental benefits and discount programs. We offer a complete PTO package for full-time colleagues including 10 paid company holidays. Our application process is 2 simple steps. 1. Apply online. 2. Take our Virtual Job Tryout to fast-track the recruitment process and start your career with CVS!
Required Qualifications • 1+ years of Customer Service experience handling and resolving customer needs over the phone • 6+ months of high-volume customer service experience working in Windows, Microsoft, or another similar application • Comfortable relating to customers in a patient and the empathic way that demonstrates a genuine concern for improving their quality of life.
Enrollment Associate Honolulu, HI
As an Outbound Enrollment Representative, you will initiate interaction with members through outbound calls, outline our health and wellness programs, and assess member willingness to participate. Additionally, the Outbound Enrollment Representative will receive calls from plan representatives and providers to address questions regarding the intake process. As part of the Intake Department, you will be responsible for completing outreach in a timely and efficient manner, educating prospective members on benefits and enrollment options, and supporting and facilitating our process related to member needs. This role is a full-time, permanent position. The regular shift would include M-F: 9-6 with one day a week rotating evening shift of 12-9 weekly. Additionally, this role would require a minimum of 6-8 weeks of training in the Greensboro, NC office. The ability to work from home is based on personal performance. We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.
Required Qualifications • 1+ years of experience in a customer service related role • 1+ years experience using Microsoft Office: Word, Excel, and Outlook.
Work From Home Michigan
]Our pharmacy has a high-energy culture and we’re passionate about providing excellent customer service with empathy, while resolving the patients’ questions on the first call. If you get satisfaction by knowing that you have helped someone, apply today. We have a comprehensive training program to ensure your success on the team.
We offer Work from Home flexibility if you meet standards. Work from Home qualifications includes but are not limited to maintaining your own internet with approved speed requirements and a secure workspace free from distractions. Adherence to HIPAA and governmental compliance is required in this role.
Schedule options are designed to create a flexible work schedule for those balancing priorities in and outside of work. Days off and hours may vary, though you will have a set schedule. Include your specific site hours here.
We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide range of supplemental benefits and discount programs. We offer a complete PTO package for full-time colleagues including 10 paid company holidays.
Our application process is 2 simple steps.
1. Apply online.
2. Take our Virtual Job Tryout to fast-track the recruitment process and start your career with CVS!
Do you enjoy working telephonically and enjoy managing multiple applications and have a passion for helping others? We provide comprehensive training to set you up for success. We also offer incredible advancement opportunities so you can grow within the pharmacy or move to another role within CVS Health.
Work from home opportunities is a unique way to provide customer service. To be eligible to work from home you must meet specific requirements such as; an enclosed space with a door, internet capability with an upload speed of 5 and a Download speed of 25, and an environment free of distractions.
(Pay to start at 17.50+)
In this role, you will be assisting members with their pharmacy benefit plans. You will take inbound calls and answer questions regarding prescription insurance, medication coverage and mail order prescriptions so that our customers better understand their coverage and options. Through your skills and knowledge, you will offer the solutions needed to help simplify their health care experience.
In response to COVID-19, we are offering Work from Home flexibility if you qualify. Qualifications include but are not limited to maintaining your own internet with approved speed requirements and a secure workspace free from distractions. Adherence to HIPAA and governmental compliance is required in this role. We have a comprehensive training program to ensure your success on the team.
Schedule options are designed to create a flexible work schedule for those balancing priorities in and outside of work. We are currently offering full-time that schedules starting at 30 hours per week. Days off and hours may vary, though you will have a set schedule. Site hours are 7 am-6 pm EST Monday-Saturday.
We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide range of supplemental benefits and discount programs. We offer a complete PTO package for full-time, colleagues including 10 paid company holidays.
Pay to start at 17.50+)Nashville, TN
In this role, you will be assisting members with their pharmacy benefit plans. You will take inbound calls and answer questions regarding prescription insurance, medication coverage, and mail order prescriptions so that our customers better understand their coverage and options. Through your skills and knowledge, you will offer the solutions needed to help simplify their health care experience.
Additionally Work from Home flexibility is an option if you qualify. Work from Home qualifications includes but are not limited to maintaining your own internet with approved speed requirements and a secure workspace free from distractions. Adherence to HIPAA and governmental compliance is required in this role. We have a comprehensive training program to ensure your success on the team.
Schedule options are designed to create a flexible work schedule for those balancing priorities in and outside of work. We are currently offering full-time schedules starting at 30 hours per week. Days off and hours may vary, though you will have a set schedule. Site hours are 6 am-10 pm 7 days a week.
We offer a comprehensive benefits package that includes medical, dental, vision insurance as well as a wide range of supplemental benefits and discount programs. We offer a complete PTO package for full-time colleagues including 10 paid company holidays.
Our application process is 2 simple steps:
1. Apply online
2. Take our Online Virtual Job Tryout (Interview Platform) to learn even more about the position--Pay Rates Starting at 17.50/hr.
Amherst, NY
Job Description Meritain Health’s Call Center has an opening for Customer Service Representatives in to support our New York location, This is a work from the home position at $17.50/ hour. This position handles customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature.
Required Qualifications – Creating a Differentiated Service Experience – Demonstrating Service Discipline – Handling Service Challenges
Preferred Qualifications – Providing Solutions to Constituent Needs – Working Across Boundaries
Education High School diploma, G.E.D. or equivalent experience
Call Center Work from Home Austin, TX
Job Description – Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests. Promotes and supports quality effectiveness of healthcare and Pharmacy Services. Evaluates authorizes approval and communicates decisions for pharmacy requests according to clinical guidelines. – Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria. Determines appropriateness for Communicatemedications. Communicates decisions to physicians, physician’s office staff, medical management staff, members, and/or pharmacists. – Will perform clinical research to support the request. – Performs non-medical research including eligibility verification, COB, and benefits verification. – Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. – Process requests in compliance with various laws and CMS regulations and company policies and procedures. – May communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies and Health Care Providers – Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services. – Sedentary work involves significant periods of sitting, talking, hearing, and keying. – Escalates requests to Pharmacists when request requires extensive clinical review or denial.
Required Qualifications – Proficiency in computerized pharmacy systems and software applications. – Excellent verbal and written communication skills. – Experience with Windows-based software applications. – National Pharmacy Technician certification and Arizona and/or Texas State License, current and in good standing, are required.” – Utilizes various proprietary systems to build, research, process and enter requests. – Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
Job Description Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services Performs intake of calls from members or providers regarding services via telephone, fax, EDI. (*) • Utilizes eTUMS and other Aetna systems to build, research and enter member information. (*) • Screens requests for appropriate referral to 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 that meets risk management, regulatory, and accreditation requirements. (*) • Promotes communication, both internally and externally to enhance the effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third-party payers as well as member, family, and health care, team members respectively) • Protects the confidentiality of member information and adheres to company policies regarding confidentiality (*) • Communicate with Aetna Case Managers, when processing transactions for members active in this Program (*) • Supports the administration of the precertification process in compliance with various laws and regulations, URAQ, and/or NCQA standards, where applicable, while adhering to company policy and procedures. (*) • Places outbound calls to providers under the direction of Medical Management Nurses to obtain clinical information for approval of medical authorizations. • Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria. • Communicates with Aetna Nurses and Medical Directors, when processing transactions for members active in this Program. • Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer-generated documents as well as a PC monitor. The working environment includes typical office conditions.
Required Qualifications High School Diploma or G.E.D.
Call Center-Jacksonville, FL
Job Responsibilities:
Initiates telephonic engagement with assigned members to introduce the program with the goal of enrolling the member in Aetna Care Management.
Effectively meets daily metrics with speed, accuracy, and a positive attitude. The metrics are focused on unique members attempted daily and the volume of members that agree to enroll in care management. This is not a sales position, enrollment is free, but influencing is important to this work.
Documentation is critical to success. The Engagement Specialist accurately and consistently document each call in the member's electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
Conducts triage, connecting members with appropriate care team personnel including care managers and customer service
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
Works efficiently and independently, meeting deliverables and deadlines
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures
Demonstrates an ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm
Other responsibilities as assigned
Required Qualifications
Experience with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records is preferred
2 years of experience preferably in customer service, telemarketing and/or sales
Call center experience preferred Familiarity with basic medical terminology preferred
Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am 8:00 pm
Strong organizational skills, including effective verbal and written communications skills
Bilingual (Spanish) preferred
Preferred Qualifications
Please see the requirements above
Education
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive, and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists, and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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Engagement Specialist – Work from Home – Call Center Harrisburg, PA
Job Responsibilities:
Initiates telephonic engagement with assigned members to introduce the program with the goal of enrolling the member in Aetna Care Management.
Effectively meets daily metrics with speed, accuracy, and a positive attitude. The metrics are focused on unique members attempted daily and the volume of members that agree to enroll in care management. This is not a sales position, enrollment is free, but influencing is important to this work.
Documentation is critical to success. The Engagement Specialist accurately and consistently document each call in the member's electronic record, thoroughly completing required actions with a high level of detail to ensure we meet our compliance requirements
Effectively supports members during enrollment calls, appropriately managing difficult or emotional member situations, responding promptly to member needs, and demonstrating empathy and a sense of urgency when appropriate
Conducts triage, connecting members with appropriate care team personnel including care managers and customer service
Demonstrates an outgoing, enthusiastic, and caring presence over the telephone.
Works efficiently and independently, meeting deliverables and deadlines
Adheres to care management, privacy and confidentiality, and quality management processes in compliance with regulatory, accreditation guidelines, company policies, and procedures
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