Inbound Outbound Queue Associate - $1000 Sign On Bonus
CVS Pharmacy - Raleigh, NC
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Job DescriptionThis is a work at home opportunity for candidates located in any time zone which includes a $1000 sign on bonus(Bonuses are only applicable to specific positions, locations, and business groups. Applicable roles have the bonus language in the job posting. Must be a new external candidate to the CVS/Aetna organization to be eligible.)-Supports comprehensive coordination of medical services including intake, screening to Aetna Medical Services Programs.-Promotes/supports quality effectiveness of Healthcare Services.-Performs intake of calls from members or providers regarding services via telephone, fax, EDI.-Utilizes MedCompass/ATV and other Aetna system to build, research and enter member information. -Screens requests for appropriate referral to medical services staff.-Approve services that do not require a medical review in accordance with the benefit plan.-Performs non-medical research including eligibility verification, COB, and benefits verification.-Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.-Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third party payers as well as member, family, and health care team members respectively)-Protects the confidentiality of member information and adheres to company policies regarding confidentialityCommunicate with Aetna Case Managers, when processing transactions for members active in this Program-Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures.-Sedentary work involving significant periods of sitting, talking, hearing and keying. -Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. -Working environment includes typical office conditions.Required Qualifications-At least 1 year of call center experience required.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications-2-4 years experience as a medical assistant, office assistant or other clinical experience.Education-High School Diploma or G.E.D.Business OverviewAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Created: 2024-09-07