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CVS Health Healthcare Eligibility Consultant in Irving, Texas

Job Description

CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for a Healthcare Eligibility Consultant to join our Eligibility Administration Department. As a Healthcare Eligibility Consultant you will impact and support customers in all areas including Commercial, Medicare, Healthcare Plans & Group Waiver Plans (EGWP).

In order to be successful in this role you will act as a client facing eligibility data subject matter expert. This will involve inputting of eligibility file and data configuration parameters within claims processing system as well as researching and consulting to improve eligibility data integrity and ensure excellent service delivery.

Other responsibilities can include improving healthcare basic analytical skills that are needed to perform data analysis, resolving eligibility file processing issues as well as consulting on healthcare data needs.

Required Qualifications

2+ years in Pharmacy Benefit Management or healthcare eligibility, insurance, IT, or benefits environment

Preferred Qualifications

Experience in customer service or client-facing experience in a fast-paced environment

Experience with EDI (Electronic Data Interchange)

Experience in a healthcare client facing role

Knowledge of ANSI X12 834 Data Documents

Experience with RxClaim and/or AS400

Bachelor's Degree in any discipline is preferred

Education

High School Diploma or GED required

Business Overview

It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country’s health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm . Please note that we only accept applications for employment via this site.

We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team at mailto:AdviceCounsel@cvshealth.com or calling 877-805-9511.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com . For technical issues with the Virtual Job Tryout, contact the Modern Hire Help Desk at 1-877-451-1695 or cvs_support@modernhire.com .

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