Support healthcare members with service coordination, intake, and referrals while working from the comfort of your home. This is a great opportunity for detail-oriented professionals who want to make a difference in healthcare access and quality.
About CVS Health
CVS Health is the nation’s leading health solutions company, connecting millions of Americans with care that is more affordable, convenient, and compassionate. With over 300,000 colleagues nationwide, we’re building a healthier future, one member at a time.
Schedule
- Full-time, 40 hours per week
- Remote, but must reside in West Virginia
- Standard business hours with flexibility based on program needs
Responsibilities
- Handle intake of calls from members or providers via phone, fax, or EDI
- Build, research, and enter member information into Aetna systems
- Screen requests for referral to medical services staff
- Approve services that don’t require medical review in accordance with plan benefits
- Conduct non-medical research, including eligibility and benefits verification
- Place outbound calls to providers to obtain or share clinical information
- Maintain accurate documentation that meets compliance, risk management, and accreditation standards
- Communicate with Aetna case managers, nurses, and medical directors when needed
- Support the administration of precertification processes in compliance with laws, regulations, and NCQA standards
- Promote confidentiality and adhere to HIPAA and company policies
Requirements
- High School Diploma or GED required
- 1–2 years of experience as a medical assistant, office assistant, or equivalent clinical role
- Must reside in West Virginia
Preferred Qualifications
- 1–2 years of call center experience
- 1–2 years of prior authorization experience
Benefits
- Competitive pay: $17.00 – $25.65 per hour
- Affordable medical, dental, and vision coverage
- 401(k) with company match + employee stock purchase plan
- Paid time off and flexible work schedules
- Family leave and dependent care resources
- Tuition assistance and career development opportunities
- Wellness programs, screenings, and confidential counseling
Join CVS Health and help members access the care they need with compassion, accuracy, and professionalism.
Happy Hunting,
~Two Chicks…