Job Description
Inbound Queue Associate-Behavioral Health
remote type
Remote
locations
Work At Home-Oklahoma
Work At Home-Georgia
Work At Home-Florida
Field-Texas
time type
Full time
job requisition id
R0117259
Job Description:
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
*Shift Available: Monday through Friday: 2:00 PM-10.30 PM EST
*Training: 10:00 AM – 6:30 PM EST, for first 6 weeks
*Holidays required.
Position Summary
inbound Queue Associate – Behavioral Health role is responsible for accepting inbound calls from facilities, providers, and members regarding pre-certification process within Medicare and Commercial Insurance.
Responsibilities to include but limited to the following:
- 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
- Other duties and responsibilities as required.
Required Qualifications
- 1 plus years of Customer Service Background
- 1 plus 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
Education
- High School Diploma or equivalent GED
