<p>We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">ourselves accountable</span> and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.</p><p style="text-align:inherit"></p><p style="text-align:inherit"></p><p style="text-align:inherit"></p><p><b>Position Summary</b><br><br><b><span>Holidays required.</span></b></p><p></p><p><span>This is a fully remote position and the following are some required Work from Home criteria which includes but is not limited to maintaining your own internet with approved speed requirements, secure workspace free from distractions, and successful completion of the training program. Download speed 25mbps or more and upload speed 10mbps or more. Hard wiring into modem will be required. </span></p><ul><li><span>Performs intake of calls from members or providers regarding services via telephone, fax, EDI.</span></li><li><span>Screens requests for appropriate referral to medical services staff.</span></li><li><span>Approve services that do not require a medical review in accordance with the benefit plan.</span></li><li><span>Performs non-medical research including eligibility verification, COB, and benefits verification.</span></li><li><span>Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.</span></li><li><span>Protects the confidentiality of member information and adheres to company policies regarding confidentiality</span></li><li><span>Communicate with Aetna Case Managers, when processing transactions for members active in this program</span></li></ul><p></p><p><b>Required Qualifications</b></p><ul><li><span>1-3 years of Customer Service Background</span></li><li><span>1-3 years of Call Center experience.</span></li></ul><p><br><b>Preferred Qualifications</b></p><ul><li><span>Familiarity with basic medical terminology and concepts </span><span>used in care management.</span></li><li><span>2-4 years experience as a medical assistant, office </span><span>assistant or other clinical experience.</span></li><li><span>Effective communication, telephonic and organization </span><span>skills.</span></li><li><span>Strong customer service skills to coordinate service </span><span>delivery including attention to customers, sensitivity to </span><span>issues, proactive identification and resolution of issues to </span><span>promote positive outcomes for members.</span></li><li><span>Computer literacy in order to navigate through </span><span>internal/external computer systems, including Excel and </span><span>Microsoft Word.</span></li><li><span>Ability to effectively participate in a multi-disciplinary </span><span>team including internal and external participants</span></li></ul><p></p><p><b>Education</b></p><ul><li><span>High School Diploma or G.E.D., equivalent experience </span></li></ul><p style="text-align:inherit"></p><p style="text-align:inherit"></p><p style="text-align:left"><b><span>Anticipated Weekly Hours</span></b></p>40<p style="text-align:inherit"></p><p style="text-align:inherit"></p><p style="text-align:left"><b>Time Type</b></p>Full time<p style="text-align:inherit"></p><p style="text-align:inherit"></p><p style="text-align:left"><b>Pay Range</b></p><p style="text-align:left">The typical pay range for this role is:</p><p style="text-align:inherit"></p>$17.00 - $31.30<p style="text-align:inherit !important"></p><p style="text-align:left !important">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. <br> </p><p style="text-align:left !important">Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p style="text-align:inherit !important"></p><p><b>Great benefits for great people</b></p><p></p><p>We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.<br><br></p>This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><span style="color:#4a4a4a"><br>Additional details about available benefits are provided during the application process and on </span><a href="https://learn.bswift.com/cvshealth-mainland" target="_blank" rel="noopener noreferrer"><span style="color:#0000ff"><u>Benefits Moments</u></span></a><span style="color:#4a4a4a">.<br><br></span></p>We anticipate the application window for this opening will close on: 06/08/2026<p style="text-align:inherit"></p><p style="text-align:inherit"></p><p style="text-align:left">Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p>