Inbound/Outbound Queue Associate – Work at Home

4004 Aetna Medicaid Administrators

Town of Florida (NY)

Hybrid

USD 23,000 - 39,000

Full time

5 days ago
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Benefits offered by this job

Medical, dental, and vision coverage
Bonus eligibility

Job summary

CVS Health in Florida is seeking an Inbound/Outbound Queue Associate to support the LTSS Service Authorization Team, handling non-clinical administrative duties, processing requests, and maintaining documentation to ensure timely approvals.

You will work with coordinators, clinical reviewers, care managers and providers in a fast-paced, high-volume environment, delivering accurate data entry, queue management and adherence to regulatory and contractual requirements.

Qualifications

  • High School Diploma or GED required.
  • Strong communication, customer service, and organizational skills.
  • Ability to work effectively in a fast-paced, high-volume operational environment.
  • Strong verbal and written communication skills.
  • Proficiency with Microsoft Office applications and data entry systems.
  • Ability to prioritize and manage multiple tasks while meeting established deadlines.
  • Strong attention to detail and commitment to accuracy.
  • Experience in healthcare, Medicaid, managed care, service authorization, administrative support, or customer service preferred.

Responsibilities

  • Manage and monitor inbound and outbound authorization work queues.
  • Receive, review, and process authorization requests and supporting documentation.
  • Review requests for completeness and identify missing or incomplete information.
  • Route authorization requests to the appropriate team or department for review and processing.
  • Process fax, email, and electronic submissions related to service authorization activities.
  • Respond to authorization-related inquiries and provide status updates as appropriate.
  • Enter and maintain accurate information within authorization and care management systems.
  • Document actions and maintain required records in accordance with established procedures.
  • Support administrative and operational workflows related to service authorizations.
  • Monitor pending requests and assist with follow-up activities necessary to support timely processing.
  • Maintain productivity, accuracy, and quality standards while managing a high-volume workload.
  • Assist with special projects, backlog reduction efforts, and operational initiatives as assigned.

Skills

Communication skills
Customer service
Organizational skills
Microsoft Office
Data entry
Healthcare experience

Education

High School Diploma or GED

Tools

Microsoft Office
Data entry systems

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 supports the Florida Long-Term Services and Supports (LTSS) Service Authorization Team (SAT) by performing non-clinical administrative and operational functions related to service authorization processing. The Associate assists with managing inbound and outbound work queues, processing authorization requests, reviewing documentation for completeness, routing requests appropriately, and supporting authorization workflows to ensure timely and accurate processing. This role works collaboratively with Service Authorization Coordinators, Clinical Reviewers, Care Managers, providers, facilities, and internal departments to support authorization operations and maintain compliance with regulatory, contractual, and organizational requirements.

Key Responsibilities
  • Manage and monitor inbound and outbound authorization work queues.
  • Receive, review, and process authorization requests and supporting documentation.
  • Review requests for completeness and identify missing or incomplete information.
  • Route authorization requests to the appropriate team or department for review and processing.
  • Process fax, email, and electronic submissions related to service authorization activities.
  • Respond to authorization-related inquiries and provide status updates as appropriate.
  • Enter and maintain accurate information within authorization and care management systems.
  • Document actions and maintain required records in accordance with established procedures.
  • Support administrative and operational workflows related to service authorizations.
  • Monitor pending requests and assist with follow-up activities necessary to support timely processing.
  • Maintain productivity, accuracy, and quality standards while managing a high-volume workload.
  • Assist with special projects, backlog reduction efforts, and operational initiatives as assigned.
Minimum Qualifications
  • High School Diploma or GED required.
  • Strong communication, customer service, and organizational skills.
  • Ability to work effectively in a fast-paced, high-volume operational environment.
  • Strong verbal and written communication skills.
  • Proficiency with Microsoft Office applications and data entry systems.
  • Ability to prioritize and manage multiple tasks while meeting established deadlines.
  • Strong attention to detail and commitment to accuracy.
  • Experience in healthcare, Medicaid, managed care, service authorization, administrative support, or customer service preferred.
How the Role Functions in FL LTSS

The Inbound/Outbound Queue Associate serves as an operational support resource for the Service Authorization Team. By managing work queues, processing requests, reviewing documentation, and supporting authorization workflows, the Associate helps ensure service authorization requests are processed accurately and within required turnaround times. This support allows authorization coordinators and clinical staff to focus on clinical review and complex authorization activities while maintaining efficient day-to-day authorization operations.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $17.00 - $28.46

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.

Benefits

Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

Application Window

We anticipate the application window for this opening will close on: 10/09/2026

EEO Statement

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

Our Work Experience

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

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