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

Assists with insurance verification and authorization, revenue cycle management, copay assistance and issue resolution and follow up. Provides support to referral sources and pharmacy team to ensure timely processing of referrals. 

Gathers necessary information to verify critical member benefits insurance coverage, such as policy numbers, group numbers, and demographic details

Reviews insurance plans and policies to determine the extent of coverage.

Contacts insurance providers to verify eligibility, coverage limits, pre-authorization requirements, and any specific benefits relevant to member services or treatments

Explains the verification process, provides updates on the status of benefits verification, and addresses any questions or concerns related to coverage or financial responsibility

Communicates any authorization requirements, coverage limitations, or pre-certification processes to ensure smooth billing and claims processing

Investigates and resolves any challenges or conflicts that may arise during the verification process, working closely with insurance providers, patients, or members to find resolutions

Proposes process enhancements, automation, or system improvements to streamline operations and enhance the overall effectiveness of benefits verification activities.  

Works with pharmacy team to provide promptly and professionally, ensuring a positive customer experience.

Schedule: Availability between 8am to 6pm Monday - Friday EST

Required Qualifications

• 1+ years of specialty pharmacy experience
• Must live within 30 miles from Charlotte, NC

Preferred Qualifications

• Prior Authorizations Experience
• Ability to multitask and be flexible to business needs
• Working knowledge of Microsoft Office

Education

• High School diploma / GED

Anticipated Weekly Hours

Time Type

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. 
 

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.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.