Inbound / Outbound Queue Associate

CVS Health Remote Position

At CVS Health, we are building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Shift Available : Tuesday-Saturday; 1 : 30pm-10 : 00pm EST. Holidays required. This is a fully remote position and the following are some required work from home criteria which includes but is not limited to maintaining your own internet with approved speed requirements, secure workspace free from distractions, and successful completion of the training program. Download speed 25mbps or more and upload speed 10 mbps or more. Hard wiring into modem will be required.

• Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
• 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.
• 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.

Required Qualifications

1-3 years of Customer Service Background. 1-3 years of Call Center experience.

Preferred Qualifications

Familiarity with basic medical terminology and concepts used in care management. 2-4 years experience as a medical assistant, office assistant or other clinical experience. Effective communication, telephonic and organization skills. Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. Computer literacy in order to navigate through internal / external computer systems, including Excel and Microsoft Word. Ability to effectively participate in a multi-disciplinary team including internal and external participants. Basic troubleshooting experience.

Education

High School Diploma or G.E.D.

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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Great Benefits for Great People

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 :

For more information, visit https : / / jobs.cvshealth.com / us / en / benefits

We anticipate the application window for this opening will close on : 11 / 29 / 2025. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex / gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.