Medicare Part D Representative - Work From Home

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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Coverage Determination/Appeals Service Representative I is responsible for working and triaging in the data entry related fax queues. The Representative I’s primary responsibilities will be to review each document with accuracy and place the case in the proper queues. Further responsibilities include researching reports, maintaining complete, timely and accurate documentation of Coverage Determination/Appeal requests and escalating issues to the Coverage Determination/Appeal pharmacists or management staff as needed.
Position will require schedule flexibility including rotations through Nights, Weekends and Holiday Coverage. All other duties are required to meet business needs.

Required Qualifications
Excellent verbal and written communication and interpersonal skills with ability to maintain patient confidentiality
2. Proficient computer skills and the ability to navigate in a Window’s based environment
3. Ability to follow directions and adapt in a dynamic work environment
4. Demonstrated problem-solving ability and attention to detail
5. Demonstrated sense of urgency with assignments
6. Strong organizational skills
7. Ability to read, analyze and interpret general business correspondence, technical procedures, and governmental regulations.
8. Ability to identify and solve practical problems and deal with a variety of concrete variables in standardized situations. Ability to perform basic mathematic calculations maybe required.
9. Ability to interpret a variety of work instructions provided through a variety of mediums

Work from Home position

Dedicated home workspace needed. Must be able to provide a quiet, uninterrupted work environment. Must have a workstation that is not accessible to common traffic and is secure from unintentional access. Must have stable personal high-speed internet and ability to hard-wire into company computer (cannot use wireless internet)

Preferred Qualifications
Please replace this section with the Preferred Job Qualifications

Education
H.S. or Equivalent

Pay Range

The typical pay range for this role is:

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 Company’s 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 Benefits | CVS Health

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.