Inbound Outbound Queue Associate

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Job Description

- This role will be to take phone calls and faxes from providers (clinics, hospitals, doctors) requesting prior authorization approval that is required for medical procedures before they can be initiated.

- As part of our non-clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our providers.

This is a busy customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone.

- Take inbound calls from providers in a call center environment.

- Data entry fax request received from an inbound fax queue.

- Assist callers from hospitals, clinics, facilities and other health care providers to create and manage requests for medical services.

- Follow processes and guidelines to determine approved services that do not require a medical review in accordance with the benefit plan.

- Complete special projects in accordance to business needs (i.e. return mail, member surveys, sorting) Promotes/supports quality effectiveness of Healthcare Services.

- Approve services that do not require a medical review in accordance with the benefit plan.

- Performs non-medical research including eligibility verification and COB.

- Protects the confidentiality of member information and adheres to company policies regarding confidentiality

- Uses Aetna Systems such as QNXT, ProFAX, and Propat.

- 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.

Pay Range

The typical pay range for this role is:

Minimum: 17.00

Maximum: 27.90

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

Required Qualifications

- Must reside in Arizona (within 2 hours of Phoenix)

- 1 year of call center experience required

- Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.

Preferred Qualifications

- 1-2 years' experience as a medical assistant, office assistant or other clinical experience preferred

- Effective communication, telephonic and organization skills.

- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.

- Ability to effectively participate in a multi-disciplinary team including internal and external participants.

Education

- High school diploma or GED

Business Overview

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. 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.

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Company info

CVS Health.
Website : https://www.cvshealth.com