Job Details

Benefit Verification Specialist

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. Coram/CVS Health is looking for a high-energy healthcare professional to join our National team as Benefit Verification Specialist. This rewarding opportunity allows you to work closely with our Patient Intake Coordinators and insurance providers to verify coverage for in-home Enteral therapy for Coram's patients. We believe that Benefit Verification Specialists are a key part of creating a positive experience for our patients. In this dynamic and fast-paced role, you will be responsible to verify insurance coverage and obtain prior authorization information for both new and existing patients in order to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers. This role will require an understanding of insurance carriers and concepts including pharmacy benefits, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.

Key Responsibilities

• Complete and document benefit verification review
• Provide information on Enteral home infusion services
• Comply with and adhere to all regulatory compliance areas, policies, and procedures, and best practices
• Coordinate with the Patient Intake Coordinators for new and existing accounts
• Investigate type and level of insurance coverage to assess patient eligibility for the program
• Communicate with medical professionals and insurance company personnel
• Complete data enter in ACIS to ensure accuracy of reporting and outcomes
• Provide input on self reviews
• Assist less experienced peers
• Perform other duties & responsibilities that are reasonable as assigned by your leaders

Required Qualifications

• Minimum 1 year experience working in a customer service or call center environment
• Data entry experience
• Working knowledge in Microsoft Office, specifically Outlook and Word

Preferred Qualifications

• Home infusion or durable medical equipment (DME) experience
• Experience work in a healthcare environment
• Experience verifying benefits with insurance companies
• Experience working with healthcare ins

Education

Verifiable High School Diploma or GED is required.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $17.00 - $31.30 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.