Inbound/Outbound Queue Associate

CVS Health Careers

. Coordinate medical services, including intake, screening, and referrals .

Posted 11/11/2026full-timeRemote • Louisiana • United StatesJuniorMid-Level💰 $17 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating medical services, including intake, screening, and referrals, while ensuring compliance with regulatory and accreditation standards. Proficient in using Aetna systems and managing member information with a focus on confidentiality and quality healthcare service delivery.

Highest-signal resume keywords

Medical Services CoordinationPrior Authorization ExperienceAetna Systems ProficiencyCall Center ExperienceEligibility Verification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Intake CoordinationBenefits VerificationReferral ScreeningDocumentation ManagementPrecertification SupportTechnical Issue ResolutionMicrosoft Office 365EHR Portal NavigationVPN LoginInternet Speed Management

Soft Skills

Effective CommunicationOpenness to LearningConfidentiality AwarenessProblem-Solving

Tools & Technologies

MedCompassQNXTProFAXProPATTeams MessagingVirtual Meeting PlatformsEmail Management

Industry Keywords

HIPAA ComplianceNCQA StandardsRisk ManagementHealthcare ServicesClinical Experience

About the role

Key responsibilities & impact

Coordinate medical services, including intake, screening, and referrals
Promote and support healthcare services quality effectiveness
Intake member and provider calls regarding services via telephone, fax, and EDI
Build, research, and enter member information in Aetna systems
Screen requests for referral to medical services staff
Approve services not requiring medical review according to the benefit plan
Conduct eligibility, COB, and benefits verification
Maintain accurate documentation meeting risk management, regulatory, and accreditation requirements
Communicate with claim administrators, plan sponsors, third-party payers, members, families, and healthcare team members
Protect member information confidentiality and follow company policies
Communicate with Aetna Case Managers, Nurses, and Medical Directors
Support precertification processes in compliance with laws, regulations, NCQA standards, and company procedures
Place outbound provider calls to provide information or obtain clinical information for medical authorization approvals
Use Aetna systems including MedCompass, QNXT, ProFAX, and ProPAT
Perform sedentary work involving extended periods of sitting, talking, hearing, and keying

Requirements

What you’ll need

1-2 years’ experience working as a medical assistant, office assistant or other clinical/equivalent experience
Call center experience preferred, 1-2 years
Prior authorization experience preferred, 1-2 years
High School Diploma, GED or equivalent experience
Direct/hardwired internet connection to a modem/router within 7 feet of the computer
Minimum internet speed of 25 Mbps download and 3 Mbps upload
Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines
Must work within the state and city where currently living
Comfortable setting up and using multiple monitors and navigating multiple applications
Ability to use email, calendar invites, Teams messaging, and virtual meetings
Experience with Microsoft Office 365 or similar Google Workspace applications
Ability to log in to secure systems such as VPN and EHR portals
Ability to manage strong passwords and recognize suspicious emails or links
Ability to resolve common technical issues independently
Openness to learning new skills
Must provide own workspace furniture

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
Company-provided equipment (keyboard, monitor, computer, headset, etc.)