Job Responsibilities : CVS Work from Home Eligibility Consultant- Electronic Ops Remote (Data Entry Jobs/No Degree)
Salary : 17.00 – $27.16 hourly
Company : CVS Health
Researched and reviewed by EffizoJobs
Eligibility Consultant- Electronic Ops
Job ID: 2217048BR
Category: Customer Service
Remote: Fully Remote, Work from Anywhere, U.S
Salary: $17.00 – $27.16 hourly
As an Eligibility Consultant you will have the opportunity to develop and maintain strong client relationships with our Medicare Advantage Group customers. You will be responsible for administrating the groups’ eligibility in accordance with the CMS Medicare Advantage guidelines. The Eligibility Consultant will maintain enrollment databases and coordinate electronic transfer of eligibility data and must have a full understanding of Medicare Guidelines and the enrollment processes.
You will accomplish this by:
• Administer client needs where you respond, research, and resolve eligibility and other enrollment related discrepancies involving member specific information.
• Participate in inter-departmental process reviews and training including special projects
• Participate in client meetings (Conference Calls and/or Onsite meetings)
• Analyze reports and communicate results to clients as you complete data entry requirements for finalizing new enrollment information as well as for changes and/or terminations.
• Reconcile enrollment discrepancies between Aetna and clients/vendors
• Participate in developing client action plans by working directly with clients/vendors, sales and other assigned account team members to achieve positive service outcomes
• Applies Centers for Medicare & Medicaid Services guidance and Aetna policies associated with technical requirements and account structure in addressing eligibility matters.
• Ensures all transactions interface accordingly with downstream systems; tests and validates data files for new or existing clients using system tools and tracks results to avoid potential problems and better address on-going service issues.
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Excellent verbal and written communication skills
Candidate must be proficient in MS Excel and Word
Problem solving skills
Customer Service background
Ability to anticipate customer needs and requirements
High School Diploma or General Equivalent Development (GED)
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services.
We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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