Inbound/Outbound Queue Associate

Job not on LinkedIn

🔥 16 hours ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $17 - $25 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 1 day.
• Jobs at this company usually fill in 21 days.

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Coordinate medical services, including intake, screening, and referrals • Promote and support healthcare services quality effectiveness • Intake member and provider calls regarding services via telephone, fax, and EDI • Build, research, and enter member information in Aetna systems • Screen requests for referral to medical services staff • Approve services not requiring medical review according to the benefit plan • Conduct eligibility, COB, and benefits verification • Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements • Communicate with claim administrators, plan sponsors, third-party payers, members, families, and healthcare team members • Protect member information confidentiality and follow company policies • Communicate with Aetna Case Managers, Nurses, and Medical Directors • Support precertification processes in compliance with laws, regulations, NCQA standards, and company procedures • Place outbound provider calls to provide information or obtain clinical information for medical authorization approvals • Use Aetna systems including MedCompass, QNXT, ProFAX, and ProPAT • Perform sedentary work involving extended periods of sitting, talking, hearing, and keying

🎯 Requirements

• 1-2 years’ experience working as a medical assistant, office assistant or other clinical/equivalent experience • Call center experience preferred, 1-2 years • Prior authorization experience preferred, 1-2 years • High School Diploma, GED or equivalent experience • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Comfortable setting up and using multiple monitors and navigating multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals • Ability to manage strong passwords and recognize suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills • Must provide own workspace furniture

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.)

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