Inbound/Outbound Que Associate

CVS Health; Baton Rouge (LA); Remote; USD 23,419 - 35,335; Full time

Benefits offered by this job

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Wellness screenings

Tuition assistance

Job summary

A national healthcare provider is seeking an Inbound/Outbound Queue Associate for a fully telework position in Baton Rouge, Louisiana. Responsibilities include intake and referral coordination, ensuring quality and compliance with medical service standards. The ideal candidate should have 1-2 years of call center experience and familiarity with medical terminology. This full-time role offers a competitive pay range and comprehensive benefits that prioritize employee wellness and work-life balance.

Qualifications

• 1-2 years of Call Center experience.
• 1-2 years of Medical Terminology experience.

Responsibilities

• Coordinates medical services including intake and referrals.
• Approves services as per benefit plan guidelines.
• Maintains documentation meeting regulatory requirements.

Skills

Call Center experience

Medical Terminology experience

Education

High School Diploma or G.E.D

Tools

eMEVS

QNXT

FAXHUB

ProPAT

MedCompass

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Inbound/Outbound Queue Associate is a fully telework position.

The schedule is Monday through Friday, 8am-5pm CST.

Responsibilities

• Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs.
• Promotes/supports quality effectiveness of Healthcare Services.
• Performs intake of calls from members or providers regarding services via telephone, fax, EDI.
• Utilizes eMEVS and other Aetna systems to build, research and enter member information.
• Screens requests for appropriate referral to medical services staff.
• Approve services that do not require a medical review in accordance with the benefit plan.
• Performs non-medical research including eligibility verification, COB, and benefits verification.
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
• Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures.
• Places outbound calls to providers under the direction of Medical Management Nurses to obtain clinical information for approval of medical authorizations.
• Uses Aetna Systems such as QNXT, FAXHUB, ProPAT, and MedCompass.
• Communicates with Aetna Nurses and Medical Directors, when processing transactions for members active in this Program.
• Sedentary work involving significant periods of sitting, talking, hearing and keying.
• Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor.
• Working environment includes typical office conditions.

Required Qualifications

• 1-2 years of Call Center experience
• 1-2 years of Medical Terminology experience

Preferred Qualifications

• 2-4 years of medical assistant experience

Education

High School Diploma or G.E.D

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is $17.00 - $25.65

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.

Great Benefits For Great People

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/30/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.