Inbound/Outbound Queue Associate

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🔥 58 minutes ago

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

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

• Supports medical prior authorization operations by taking inbound calls from members and providers • Builds cases in multiple systems • Ensures accurate documentation and HIPAA-compliant handling of PHI/PII

🎯 Requirements

• 1+ year of customer service/call center experience (healthcare, health insurance, or medical office preferred) • Familiarity with health insurance concepts and workflows (e.g., prior authorization/precertification, utilization management, benefits, claims terminology) • Working knowledge of HIPAA privacy practices and ability to handle PHI/PII appropriately • Comfort navigating multiple computer applications at once (case tools/CRM, web portals) with accurate, fast data entry • Strong verbal communication, active listening, documentation, and de-escalation skills • Must be on camera during training

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility

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