Care Coordination Specialist for Transplant Services

CVS Health; Tennessee; Remote; USD 25,000 - 48,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a dedicated coordinator to support the National Medical Excellence Program, handling inbound calls and coordinating medical information. The role involves using Aetna systems to build and verify member data, performing eligibility and benefits checks, and ensuring compliant documentation.

The ideal candidate has strong communication skills and thrives in a team environment. The position offers full-time hours, with a typical 40-hour work week, and a comprehensive benefits

Qualifications

• 2+ years’ experience as a medical assistant, office assistant or similar clinical/equivalent role.
• Proficient in Microsoft Office, especially Excel.
• Ability to communicate with diverse populations.
• Able to collaborate in a team environment.
• Flexible and able to work independently.

Responsibilities

• Perform intake of calls from providers or members.
• Use Aetna systems (MedCompass, HRP, ASD, CEC, ATV) to build and enter member information.
• Conduct non-medical research: eligibility verification, COB, and benefits verification.
• Maintain accurate documentation to meet risk, regulatory and accreditation requirements.
• Handle intake of calls from members or providers via telephone, fax or EDI.
• Process referrals, make outreach calls, and enter data as needed.
• Coordinate with clinical team, medical directors, claims and contacting staff.
• Communicate with transplant financial coordinator at the transplant center.
• Initiate authorizations for kidney transplants per unit processes.
• Communicate with members/providers regarding transplant services.
• Support precertification in line with applicable laws and NCQA standards.
• Protect confidentiality of member information per company policy.
• Other duties as assigned.

Skills

Medical Assistant experience

MS Office (Excel)

Communication with diverse populations

Team collaboration

Independent work / adaptability

Education

High School Diploma or GED

Associate Degree preferred

Tools

Microsoft Office Suite

Job description

CVS Health is seeking a dedicated coordinator to support the National Medical Excellence Program, handling inbound calls and coordinating medical information. The role involves using Aetna systems to build and verify member data, performing eligibility and benefits checks, and ensuring compliant documentation.

The ideal candidate has strong communication skills and thrives in a team environment. The position offers full-time hours, with a typical 40-hour work week, and a comprehensive benefits