Inbound/Outbound Queue Associate

Job not on LinkedIn

🔥 2 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $17 - $31 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.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

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Support comprehensive coordination of medical services, including intake, screening, and referrals to Aetna Better Health • Promote and support quality effectiveness of Healthcare Services • Perform intake of member and provider calls regarding services via telephone, fax, and EDI • Use Aetna systems to build, research, and enter member information • Screen requests for appropriate referral to medical services staff • Approve services that do not require medical review according to the benefit plan • Perform non-medical research, including eligibility, COB, and benefits verification • Maintain accurate 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 member confidentiality and follow company confidentiality policies • Communicate with Aetna Case Managers, Nurses, and Medical Directors when processing member transactions • Support precertification administration in compliance with laws, regulations, NCQA standards, and company procedures • Place outbound calls to providers to provide information or obtain clinical information for medical authorization approval • Use MedCompass, QNXT, ProFAX, and ProPAT systems

🎯 Requirements

• 1-2 years experience working as a medical assistant, office assistant or other clinical/equivalent experience • 1-2 years call center experience • High School Diploma, GED or equivalent experience • 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 • Associates degree, preferred • Prior authorization experience, 1-2 years, preferred

🏖️ Benefits

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