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
The Advanced Eligibility Consultant is responsible for our most complex and highest valued clients. The Advanced Eligibility Consultant will also work and resolve complex issues. They translate direction and intent into actionable items while operating with minimal supervision. This person is consultative in nature when working with other departments, clients, and brokers. They coach and mentor junior staff, develop and execute training plans, coordinate and set daily objectives, identify and implement process improvements and efficiencies, and function as our highest level of escalation prior to manager/director involvement.
The Advanced Eligibility Consultant will establish and maintain processes regarding billing and claims processing, insurance verification and authorization, revenue cycle management, and compliance & documentation, as well as customer service and issue resolution. They will reconcile and solve issues to ensure accurate billing, facilitate smooth revenue flow, maintain compliance, and provide satisfactory customer experiences.
Required Qualifications:
- 2+ years of experience with eligibility, particularly within the commercial health insurance industry, including a demonstrated proficiency in processing accurate and timely policy and eligibility data, ensuring services and products meet the plan sponsor needs.
- Must reside in Lansing, MI or Plymouth, MN.
- Ability to work a hybrid schedule (3 days in the office per week).
Preferred Qualifications:
- Ability to manage multiple tasks/priorities.
- Understands intent/end state and operates with minimal guidance to meet that intent/end state.
- Team player capable of operating independently when needed.
- Ability to provide accurate and timely results.
- Ability to delegate and follow up as needed.
- Ability to coach and mentor others.
- Experience as a Senior Eligibility Consultant and/or Senior Eligibility Analyst.
- Bachelors degree
Education:
- High school diploma or GED + 4 years of relevant experience.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$43,888.00 - $93,574.00This 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.
More Information
Application Details
- Organization Details4062 Aetna Resources, LLC
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