[Hiring] Benefits Verification Representative @CVS Health

Role Description

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: 9:00am - 5:30pm, Monday - Friday EST

Qualifications

• 1+ years of specialty pharmacy experience

Requirements

• 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

• 40

Time Type

• Full time

Pay Range

The typical pay range for this role is: $17.00 - $25.65. 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.

Benefits

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Application Information

We anticipate the application window for this opening will close on: 02/28/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.