Eligibility Consultant

CVS Health

. Manage the most complex and highest valued clients .

Posted 10/22/2026full-timeUnited StatesJuniorMid-Level💰 $43,888 - $93,574 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing complex client relationships and resolving intricate issues within the commercial health insurance industry. Proficient in eligibility processing, revenue cycle management, and compliance, while effectively coaching and mentoring junior staff.

Highest-signal resume keywords

Eligibility ProcessingRevenue Cycle ManagementClient Relationship ManagementCoaching And MentoringProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Policy Data ProcessingClaims ProcessingInsurance VerificationDocumentation ComplianceIssue Resolution

Soft Skills

Team PlayerIndependent OperationTask ManagementDelegationCommunication

Industry Keywords

Commercial Health InsuranceBillingEligibility DataCustomer ServiceCompliance

About the role

Key responsibilities & impact

Manage the most complex and highest valued clients
Work and resolve complex issues
Translate direction and intent into actionable items with minimal supervision
Consult with other departments, clients, and brokers
Coach and mentor junior staff
Develop and execute training plans
Coordinate and set daily objectives
Identify and implement process improvements and efficiencies
Function as the highest level of escalation prior to manager/director involvement
Establish and maintain processes for billing and claims processing, insurance verification and authorization, revenue cycle management, compliance and documentation, customer service, and issue resolution
Reconcile and solve issues to ensure accurate billing
Facilitate smooth revenue flow
Maintain compliance
Provide satisfactory customer experiences

Requirements

What you’ll need

2+ years of experience with eligibility, particularly within the commercial health insurance industry
Demonstrated proficiency in processing accurate and timely policy and eligibility data
Must reside in Lansing, MI or Plymouth, MN
Ability to work a hybrid schedule (3 days in the office per week)
Ability to manage multiple tasks/priorities
Understands intent/end state and operates with minimal guidance
Team player capable of operating independently when needed
Ability to provide accurate and timely results
Ability to delegate and follow up as needed
Ability to coach and mentor others
Experience as a Senior Eligibility Consultant and/or Senior Eligibility Analyst
High school diploma or GED + 4 years of relevant experience

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay