Inbound/Outbound Queue Associate-Behavior Health
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. This is a fully remote WFH position. Shift Required: Sunday to Thursday 8:30 AM – 5:00 PM EST Training: 8:00 AM - 4:30 PM EST, Monday-Friday, for first 8 weeks (remote) Some Holidays required. Shift Differential will be included. Position Summary Inbound Queue Associate - Behavioral Health role is responsible for accepting inbound calls from facilities, providers, and members regarding pre-certification process within Medicare and Commercial Insurance.
Requirements
- 1 plus years of Customer Service Background
- 1 plus years of Call Center experience
- Reliable internet connection (25 Mbps download speed, 10 Mbps upload plan)
- Quiet work environment
- High School Diploma or equivalent GED required
Nice To Haves
- Familiarity with basic medical terminology and concepts used in care management.
- 2-4 years experience as a medical assistant, office assistant or other clinical experience.
- 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.
- Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants
- Ethernet hookup preferred
Responsibilities
- Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
- Screens requests for appropriate referral to medical services staff.
- Approve services that do not require a medical review in accordance with the benefit plan.
- Performs non-medical research including eligibility verification, COB, and benefits verification.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality
- Communicate with Aetna Case Managers, when processing transactions for members active in this program
- Other duties and responsibilities as required.
Benefits
- 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.
- Additional details about available benefits are provided during the application process and on Benefits Moments.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
