Experienced Inbound/Outbound Queue Associate - Remote Medical Services Coordination for CVS Health

Transforming Healthcare through Compassionate Service At CVS Health, our mission is to bring our heart to every moment of your health. As a leader in the healthcare industry, we're committed to delivering enhanced human-centric health care that's both personal and convenient. Our team is guided by a clear purpose and supported by our Heart At Work Behaviors, which empower us to innovate and make a meaningful difference in the lives of our customers. Job Overview We're seeking an experienced Inbound/Outbound Queue Associate to join our team at Workwarp, a CVS Health company. As an Inbound/Outbound Queue Associate, you'll play a critical role in coordinating medical services, ensuring seamless communication between members, providers, and our healthcare team. This is an exciting opportunity to work remotely and be part of a dynamic team that's shaping the future of healthcare. Key Responsibilities Coordinate medical services, including intake, screening, and referrals to Aetna Better Health Respond to inbound calls from members and providers, and make outbound calls to providers to obtain or provide clinical information Utilize Aetna systems, such as MedCompass, QNXT, SSA, ProFAX, and ProPAT, to build, research, and enter member information Screen requests for appropriate referral to medical services staff and approve services that don't require medical review Perform non-medical research, including eligibility verification, COB, and benefits verification Maintain accurate and complete documentation, adhering to risk management, regulatory, and accreditation requirements Communicate effectively with internal stakeholders, including Aetna Case Managers, Nurses, and Medical Directors Protect member confidentiality and adhere to company policies regarding confidentiality Essential Qualifications To succeed in this role, you'll need: 1-2 years of experience working as a medical assistant, office assistant, or in a clinical/equivalent role Residency in Florida High School diploma or equivalent GED Preferred Qualifications While not required, the following experience will give you a competitive edge: 1-2 years of call center experience 1-2 years of prior authorization experience Skills and Competencies To excel as an Inbound/Outbound Queue Associate, you'll need: Excellent communication and interpersonal skills Strong analytical and problem-solving skills Ability to work in a fast-paced environment, managing multiple tasks and priorities Proficiency in using various software applications, including Aetna systems Strong attention to detail and organizational skills Career Growth and Learning Benefits At CVS Health, we're committed to helping you grow and develop your skills. As an Inbound/Outbound Queue Associate, you'll have access to: Ongoing training and development programs Opportunities for career advancement within the company Collaborative and dynamic work environment that fosters innovation and teamwork Work Environment and Company Culture As a remote team member, you'll enjoy the flexibility and autonomy to work from home while still being connected to our vibrant company culture. Our employees are self-disciplined, hardworking, curious, trustworthy, humble, and truthful, and we encourage a culture of collaboration and teamwork. Compensation and Benefits We offer a competitive salary range of $17.00 - $25.65 per hour, depending on your experience and qualifications. In addition to your base pay, you'll be eligible for a CVS Health bonus, commission, or short-term incentive program. Our comprehensive benefits package includes: Medical, dental, and vision benefits 401(k) retirement savings plan and Employee Stock Purchase Plan Fully-paid term life insurance plan and short-term and long-term disability benefits Well-being programs, education assistance, and free development courses CVS store discount and discount programs with participating partners Paid Time Off (PTO) and paid holidays throughout the calendar year Join Our Team If you're a motivated and compassionate individual ready to make a difference in the healthcare industry, we encourage you to apply now. We're excited to review your application and discuss this opportunity further. At CVS Health, we're committed to creating a workplace that's inclusive and equitable for all employees. We anticipate the application window for this opening will close on 10/29/2024. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. Apply for this job