Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. 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** - Must reside in the Dallas/ Fort Worth Texas area Establishes and maintains processes regarding billing and claims processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Reconciles and solves issues to ensure accurate billing, facilitate smooth revenue flow, maintain compliance, and provide satisfactory customer experiences. Additional responsibilities to include but not limited to the following: - On-board Pharmacy member electronic file from clients or vendors - Work with application development on custom files - Submit request for File Transfer Protocol to the Connectivity Team - Gather eligibility file requirements **Required Qualifications** - 1 year of experience in Pharmacy Benefits Management (PBM) or health plan eligibility with experience in a client-facing role in a fast-paced environment. - 1 year of demonstrated expertise in aligning key PBM concepts and data fields across diverse systems and file formats, including proficiency with EDI 834, to ensure data transfer consistency and accuracy. - Proven track record of effectively executing, testing, and maintaining critical operational tasks. - Microsoft Office (Word, Excel, Access DB, Info Path) **Preferred Qualifications** - Proficiency in Excel, and other technical data skills. - Self-motivated individual with a keen eye for detail and a knack for solving complex problems. - Capable of managing multiple competing priorities in a dynamic environment and collaborating effectively within a team setting. - Excellent communication skills, time and project management, problem solving, analytical skills, and with a demonstrated ability to cultivate productive relationships with both internal and external stakeholders - Bachelor's Degree preferred. **Education** High School Diploma or equivalent GED **Pay Range** The typical pay range for this role is: $43,888.00 - $85,068.00 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 (https://jobs.cvshealth.com/us/en/benefits) We anticipate the application window for this opening will close on: 12/20/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.