Eligibility Consultant - Paper Operations

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 supports multiple health plans:

• Verify member enrollment status
• Make changes to member - demographics, effective and term dates
• Addresses a variety of enrollment questions or concerns from the health plan / state
• Manual QNXT updates on all fall out edits from the daily, weekly, monthly, quarterly electronic enrollment files
• Manually update urgent request received via email from the health plan / state
• Work claim inquiries (H03s)
• Manually enter temp newborns
• Review and manually update all reconciliation reports received from Finance
• Responds, researches, and resolves eligibility related issues involving member specific information
• Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters.
• Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership  and partnering with appropriate internal/external support areas involving any requests for  customization.
• Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations.
• Partners with other team functions to coordinate the release of eligibility and benefit plan information.

• Customer Service experience.
• Attention to detail and accuracy.
• Problem solving skills.
• Strong organization skills.
• Understands the impact of work to other teams and downstream support areas.
• Ability to analyze and research data to make appropriate corrections as necessary.
• Strong verbal and written communication skills.
  
  Workplace flexibility - ability to adapt to change

• Knowledge of Health Care and/or MCO's.
• Knowledge of Enrollment.
• Knowledge Medicaid and/or Medicare.
• Knowledge and comfortability with learning different systems and using Excel

High School diploma

40

Full time

The typical pay range for this role is:

$17.00 - $28.46

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.

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.

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: 02/28/2026

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