Benefits Verification Representative, Work From Home Charlotte, NC
CVS Health · Raleigh, NC
- Hybrid
- Full-time
- $43,680 / year
- Raleigh, NC
Job highlights
- Verify member insurance coverage and benefits.
- Communicate with insurance providers for eligibility and pre-authorization.
- Resolve issues and ensure timely processing of referrals.
- Propose process improvements for efficiency.
- Provide excellent customer service to pharmacy team.
About the role
Benefits Verification Representative - Work From Home
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
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: Availability between 8am to 6pm Monday - Friday EST
Required Qualifications
- 1+ years of specialty pharmacy experience
- Must live within 30 miles from Charlotte, NC
Preferred Qualifications
- 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.
Our Commitment to Our People
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. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 07/03/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Key skills/competency
- Benefits Verification
- Insurance Verification
- Revenue Cycle Management
- Authorization
- Specialty Pharmacy
- Customer Service
- Problem Solving
- Process Improvement
- Microsoft Office
- Communication
Skills & topics
- Benefits Verification
- Insurance Verification
- Specialty Pharmacy
- Revenue Cycle Management
- Authorization
- Customer Service
- Problem Solving
- Pharmacy Operations
- Healthcare Administration
- Data Entry
How to get hired
- Tailor your resume: Highlight 1+ years of specialty pharmacy experience and any prior authorization experience. Quantify achievements in insurance verification and issue resolution.
- Craft a compelling cover letter: Emphasize your understanding of CVS Health's mission and how your skills in benefits verification align with their commitment to simplifying healthcare.
- Prepare for behavioral questions: Be ready to discuss your problem-solving abilities, how you handle multitasking, and your experience in customer service within a pharmacy setting.
- Showcase your technical skills: Mention your working knowledge of Microsoft Office and any familiarity with revenue cycle management systems or similar tools.
- Demonstrate local ties: Clearly state your proximity to Charlotte, NC (within 30 miles) to meet the location requirement.
Technical preparation
Behavioral questions
Frequently asked questions
- What is the primary responsibility of a Benefits Verification Representative at CVS Health?
- The primary responsibility of a Benefits Verification Representative at CVS Health is to assist with insurance verification and authorization, revenue cycle management, and copay assistance to ensure timely processing of referrals and a positive customer experience.
- What experience is required for the Benefits Verification Representative role at CVS Health?
- The role requires at least 1 year of specialty pharmacy experience. A high school diploma or GED is also required. Prior authorization experience and working knowledge of Microsoft Office are preferred.
- Is the Benefits Verification Representative position at CVS Health remote?
- This position is a work-from-home role, but candidates must live within 30 miles of Charlotte, NC, to be considered for the Benefits Verification Representative position.
- What are the working hours for a Benefits Verification Representative at CVS Health?
- The schedule for the Benefits Verification Representative position requires availability between 8 am and 6 pm EST, Monday through Friday.
- What is the pay range for a Benefits Verification Representative at CVS Health?
- The typical pay range for this role is $17.00 - $25.65 per hour, with potential eligibility for CVS Health bonuses, commissions, or short-term incentive programs.
- What benefits does CVS Health offer for this Benefits Verification Representative role?
- Full-time employees are eligible for a comprehensive benefits package including medical, dental, and vision coverage, paid time off, retirement savings options, and wellness programs.
- How does CVS Health handle candidates with arrest or conviction records for the Benefits Verification Representative position?
- CVS Health considers qualified applicants with arrest or conviction records in accordance with all federal, state, and local laws for the Benefits Verification Representative position.
- What kind of process improvements might a Benefits Verification Representative suggest at CVS Health?
- A Benefits Verification Representative might suggest process enhancements, automation, or system improvements to streamline operations and enhance the overall effectiveness of benefits verification activities at CVS Health.