Benefits Verification Specialist

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Job Description
A Brief Overview
Assists with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.

What You Will Do

• 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 for different medical procedures, treatments, medications, or services.
• 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.
• Maintains accurate and detailed records of insurance verification activities, including documenting conversations, collecting insurance information, and updating patient or member profiles.
• 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.
• Responds to member inquiries and concerns promptly, empathetically, and professionally, ensuring a positive customer experience.

For This Role You Will Need Minimum Requirements

• Less than 1 year work experience

Preferred Qualifications

• Certified Professional, Life and Health Insurance Program (CPLHI) preferred.
• Certified Employee Benefit Specialist (CEBS) preferred.

Education

• High School Diploma

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range
The Typical Pay Range For This Role Is
$ $31.30

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.

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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.

For more information, visit

We anticipate the application window for this opening will close on: 01/25/2026

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