Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

• The Eligibility Audit process reviews work of Eligibility and COBRA Specialists to validate they are entering transactions correctly into the processing system (DG). This includes eligibility transactions sent by paper, electronic files, and entered by the client via the web.
• Transaction accuracy is evaluated using internal procedures, plan documents, industry standards, and government compliance documentation. Errors and results are communicated to the Eligibility Specialist and Supervisor. Monthly error analysis reports are created and shared with Eligibility management to evaluate individual and Eligibility team performance.
• Producing accurate and complete audit results with an understanding and concern for the steps and tasks involved in the process being audited is required.
• Following stated internal procedures, conduct research, obtain clarification of information, to ensure that all decisions made take into account the expected outcome and the effect decisions and actions have on other processes.
• Create and maintain appropriate documentation to provide timely feedback of audit results and identification of trends.
• Identify, document, and report compliance issues with respect to industry standards, state and federal guidelines.
• Teamwork is an essential component of this position due to the need for collaboration with other departments to resolve issues and deliver optimal results for our clients.

• At least 1 year in a production-based environment

• Prior auditing experience a plus
• Knowledge of the DG, WEX, and other Meritain processing systems preferred
• Basic knowledge of Excel
• Attention to detail
• Effective and professional written and verbal communication skills
• Strong investigative skills
• Ability to interpret Plan Document language
• Ability to multi-task and set appropriate priorities
• Ability to work independently with little guidance

• High School diploma or GED