Sr Rep,Benefits Verification Apply
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Position Summary
Coram/CVS Health is looking for a high-energy healthcare professional to join our national team as a Senior Benefits Specialist Lead! This rewarding opportunity allows you to work closely with our Patient Intake Coordinators and insurance providers to verify coverage for in-home IV therapy for Coram's patients. We believe that Senior Benefit Verification Specialists are a key part of creating a positive experience for our patients.
In this dynamic and fast-paced role, the Senior Benefit Verification Specialists is a Team Lead over Benefit Verification team members and will be required to have an understanding of insurance carriers and concepts including drug cards, major medical benefits, and per diem coverage as well as knowledge of government and patient assistance programs.
Your responsibilities for this position would be but not limited to:
- Be available to answer questions and support the Benefit Verification team members
- Manage efficient day to day operations for the benefit verification of patients with payors that have unique qualifications while verifying their specific billing requirements for claim submission
- Ensure reference tools such as: PPRGs/Billing Grids/Other Documentation are available and are used by our Benefit Specialists to best assist them with completing the Core Patient Referrals. Or assist other such as our Pharmacies with questions they may have.
- Work Referrals by verifying medical benefits, running test claims, eligibility and completing estimates as needed for patients prior to the start of care.
- Submit requests for any updates needed to reference tools such as: PPRGs/Billing Grids/Other Documentation
- Review New Payers not in Epic and submit for new payer requests as needed.
- Manage Benefits Leader Inbox via Outlook.
- Provide clear detailed responses to questions that the pharmacy has regarding to benefits.
- Escalate any unassigned referrals to team.
- Provide feedback to Benefit Specialists when a training opportunity arises after we receive a concern of an error to help prevent same errors in future.
- Complete Quality Assurance audits on Benefit Specialists.
- Assist in the training of New Benefit Specialists once they are out of training class.
- This is a full-time benefited position and is NOT through an agency. Typical work hours are Monday-Friday with hours between 7am-8pm CST with mandatory overtime including possibility of weekends/holidays per business need. This is a Work At Home role, which requires access to an appropriate work space that will ensure HIPPA compliance, privacy and consistent internet strength and availability.
Required Qualifications
- Analytical and problem-solving skills
- Attention to detail
- Minimum 2 Years of experience in Customer Service and/or minimum 2 years of experience in healthcare.
- Data entry experience
- Minimum 1 Year of Experience working in Microsoft Office, specifically Excel, Outlook, and Word
Preferred Qualifications
- Minimum one year experience working in a healthcare environment
- Previous Benefit Verification knowledge of Medicare, Medicaid, Pharmacy Benefit Managers, and third-party vendors
- Epic experience
Education High School Diploma or GED Equivalent required
Pay Range
The typical pay range for this role is:
$18.50 - $35.29
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.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health colleagues can initiate a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through myHR (1-888-694-7287, or through myLeave at myHR). If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Pay Range
The typical pay range for this role is:
$18.50 - $35.29
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 Companys 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
We anticipate the application window for this opening will close on: 03/25/2024
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
