Health Eligibility & Enrollment Specialist

CVS Health; Lansing (MI); On-site; USD 23,000 - 47,000; 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 an Enrollment Specialist to verify member enrollment status, update records, and answer inquiries under general supervision. You will maintain enrollment databases and coordinate electronic transfers of eligibility data.

You will respond to eligibility questions and coordinate with clients, field offices, and claim operations to achieve positive service outcomes, ensuring compliance with HIPAA and regulatory policies while supporting downstream processing and reporting.

Qualifications

• 1+ years of customer service experience.
• 1+ years of data entry experience.
• Ability to type at least 35 WPM.
• Excellent verbal and written communication skills.
• Experience with Word and proficiency in Excel.

Responsibilities

• Verify enrollment status and update member/client records.
• Maintain enrollment databases and coordinate electronic transfer of eligibility data.
• Respond to and resolve enrollment questions and concerns.
• Apply policy, regulatory, and benefit parameters to eligibility matters.
• Develop tools and provide coding supplements and data specs to clients/vendors.
• Act as liaison between clients, vendors, and IT for testing non-standard arrangements.
• Ensure transactions interface with downstream systems and validate data files for new/existing clients.
• Coordinate release of eligibility, plan structure and benefit information with other teams.
• Complete setup of policy and eligibility screens to activate system processing.
• Code system screens and structure to support downstream processes (ID cards, etc.).
• Ensure compliance with HIPAA and other regulations in client activity.
• Use online resources to understand account structure and benefits; contribute to resource development as needed.
• Communicate standard service charges for electronic eligibility activities; negotiate for non-standard services.

Skills

Customer service

Data entry

Typing

Communication

Education

High School diploma or GED

Tools

Microsoft Word

Microsoft Excel

Job description

CVS Health is seeking an Enrollment Specialist to verify member enrollment status, update records, and answer inquiries under general supervision. You will maintain enrollment databases and coordinate electronic transfers of eligibility data.

You will respond to eligibility questions and coordinate with clients, field offices, and claim operations to achieve positive service outcomes, ensuring compliance with HIPAA and regulatory policies while supporting downstream processing and reporting.