Inbound/Outbound Queue Associate

Job not on LinkedIn

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $17 - $25 / 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 • Promote and support quality effectiveness of Healthcare Services • Perform intake of member or 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 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 member information confidentiality and follow company confidentiality policies • Communicate with Aetna Case Managers, Nurses and Medical Directors when processing applicable member transactions • Support precertification administration in compliance with laws, regulations and/or NCQA standards • 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 • Inspect written and computer-generated documents and PC monitor information

🎯 Requirements

• 1-2 years’ experience working as a medical assistant, office assistant or other clinical/equivalent experience • High School Diploma, GED or equivalent experience • Ability to obtain a 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 • WiFi and satellite internet are not permitted • Quiet, secure and private designated home virtual work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Must provide workspace furniture, such as a desk or standing desk • Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging and virtual meetings • Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals • Knowledge of computer security practices, including locking screens, managing strong passwords and recognizing suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills as the workplace evolves • Associates degree preferred • Call center experience preferred, 1-2 years • Prior authorization experience preferred, 1-2 years

🏖️ 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 based on eligibility • Company-provided equipment (keyboard, monitor, computer, headset, etc.)