Role Description 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. • Schedule Sunday-Thursday 12PM-830PM EST • Holidays required. • This is a fully remote position with required Work from Home criteria, including • Maintaining your own internet with approved speed requirements • Secure workspace free from distractions • Successful completion of the training program • Download speed 25mbps or more; Upload speed 10mbps or more • Hard wiring into modem will be required. • 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. Qualifications • 1-3 years of Customer Service Background • 1-3 years of Call Center experience. Requirements • 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. Education • High School Diploma or G.E.D., equivalent experience Benefits • Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families, including • Medical, dental, and vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources, based on eligibility