CVS Health

Eligibility Consultant – Paper Ops

CVS Health

full-time

Posted on:

Location Type: Remote

Location: Remote • Idaho, Pennsylvania, Texas, Vermont • 🇺🇸 United States

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Salary

💰 $17 - $34 per hour

Job Level

Mid-LevelSenior

About the role

  • Verify member enrollment status
  • Make changes to member demographics, effective and term dates
  • Address a variety of enrollment questions or concerns from the health plan/state
  • Manual QNXT updates on all fall out edits from the daily, weekly, monthly, quarterly electronic enrollment files
  • Manually update urgent requests received via email from the health plan/state
  • Work claim inquiries (H03s)
  • Manually enter temp newborns
  • Review and manually update all reconciliation reports received from Finance
  • Respond, research, and resolve eligibility related issues involving member specific information
  • Validate benefit plan enrollment information for assigned clients for accuracy and completeness; coordinate the distribution of membership ID cards and partner with appropriate internal/external support areas involving any requests for ID card customization
  • Complete data entry requirements for finalizing new enrollment information as well as for changes and/or terminations
  • Partner with other team functions to coordinate the release of eligibility and benefit plan 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
Benefits
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
data entrymanual updateseligibility verificationreconciliation reportingenrollment processingclaim inquiriesmember demographics managementbenefit plan validationID card customizationQNXT
Soft skills
customer serviceattention to detailproblem solvingorganizationcommunicationflexibilityresearch skillsadaptabilitycollaborationaccuracy
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