Inbound/Outbound Queue Associate

Job not on LinkedIn

🔥 12 hours ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $17 - $31 / 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.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Support comprehensive coordination of medical services, including intake, screening, and referrals • Promote and support quality effectiveness of Healthcare Services • Perform intake of calls from members or providers regarding services via telephone, fax, and EDI • Utilize Aetna systems to build, research, and enter member information • Screen requests for appropriate referral from medical services staff • Approve services that do not require medical review in accordance with the benefit plan • Perform non-medical research including eligibility, COB, and benefits verification • Maintain accurate and complete documentation meeting risk management, regulatory, and accreditation requirements • Promote internal and external communication with claim administrators, Plan Sponsors, third-party payers, members, families, and healthcare team members • Protect confidentiality of member information and adhere to company confidentiality policies • Communicate with Aetna Case Managers, Nurses, and Medical Directors when processing member transactions • Support administration of the precertification process in compliance with laws, regulations, NCQA standards, and company policies • Place outbound calls to providers to provide information or obtain clinical information for approval of medical authorizations • Use Aetna systems such as MedCompass, QNXT, ProFAX, and ProPAT

🎯 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 • Ability to work between 8am-6pm EST • No weekends • Ability to perform sedentary work involving significant periods of sitting, talking, hearing, and keying • Visual acuity to perform close inspection of written and computer-generated documents and a PC monitor

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to the base pay range • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility

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