Eligibility Analyst

CVS Health

1d•Onsite

About The Position

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 ourselves accountable 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. Position Summary CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for an Eligibility Analyst to join our Eligibility Administration Department. As an Eligibility Analyst for a Fortune 10 organization, you will impact and support customers in all areas including Commercial, Medicare, Medicaid, & Healthcare Plans.

Requirements

1+ year(s) in healthcare data eligibility, insurance, IT, benefits, or data analytics environment with a strong ability to work independently, problem solve, and analyze data in a confidential healthcare environment
2+ years customer service experience in a fast-paced environment
Strong written and verbal communication skills
Ability to communicate with business clients and stakeholders in a professional manner

Nice To Haves

3+ years experience in eligibility or other relevant background
Experience in EDI (Electronic Data Interchange)
Understanding of the PBM industry
Familiarity with RxClaim and/or AS400
Pharmacy technician or benefits verification experience

Responsibilities

Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients
Researching and consulting to improve healthcare data integrity and ensure excellent service delivery
Constantly improving healthcare analytical skills that are needed to perform data analysis
Resolving data enrollment issues on a daily basis
Consulting on healthcare data needs
Having exceptional time management and healthcare client management skills
Continuous development training will be provided in this role to ensure the Eligibility Analyst is able to exceed client expectations in this fast-paced environment