Client Benefit Representative II

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.

Position Summary

Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance.

Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.

What you will do

·         Configures benefits programs within the healthcare company's systems or databases.

·         Inspects plan details, coverage options, eligibility criteria, and other relevant information based on the specific benefits plans offered by the company.

·         Processes member or subscriber enrollments into the benefits programs by entering enrollment data, verifying eligibility based on plan requirements, and ensuring accurate and timely enrollment for individuals or groups.

·         Reviews and verifies the eligibility of members or subscribers for various benefits programs.

·         Handles adding or modifying coverage options, plan structures, cost-sharing arrangements, or other plan-related details based on member needs.

·         Ensures the accuracy and integrity of data related to benefits program setup by reviewing and validating data entries, performing data audits, and making corrections or updates as needed to maintain accurate and up-to-date information.

·         Organizes documentation and records of benefits program setup activities, including plan configurations, enrollment data, eligibility determinations, and any modifications or updates made.

·         Assists in providing regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development.

Communicates with various internal teams, such as benefits administration, HR, or IT, to gather and exchange information related to benefits setup and enrollment

Requirements

• 2-3 years of direct work experience with PBM knowledge
• Proficient use Microsoft Office applications, e.g. Excel, Word
• Experience with AS400 / RxCLAIM
• Working knowledge of SalesForce.com

Preferred Qualifications

• Certified Pharmacy Technician

• Well organized with the ability to prioritize work

  effectively and independently

• Flexible in adapting to change

• Excellent time management skills

• Excellent interpersonal and collaborative skills with the ability to work in a team environment

• Ability to work successfully in a deadline-oriented environment

• Excellent verbal and written communication skills

• Strong analytical skills and attention to detail. Ability to define problem, review data, establish facts, and draw valid conclusions

Education

·         High School Diploma

Pay Range

The typical pay range for this role is:

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

Salary : $17 - $30