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Customer Service Representative, Medical Review/Accident & Health

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Franklin

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Category:
Customer Service

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Contract Type:
Not provided

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Salary:

17.00 - 28.46 USD / Hour
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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.

Job Responsibility:

  • Operates as a representative of the company by answering and documenting all incoming contacts to determine their nature while responding to complex calls related to specialized services
  • Ensures that every member is shown respect and kindness and that all questions are thoroughly answered to ensure a high level of customer satisfaction and loyalty
  • Identifies and evaluates appropriate data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery
  • Follows established procedures to meet customer/member needs and successfully enhance the company's brand recognition and competitive advantage in the industry
  • Handles the answering of questions regarding A&H and FE plans so that our members better understand their coverage
  • Communicates effectively with diverse work units and relevant organizational departments to ensure that issues are properly and quickly resolved
  • Performs required tasks using tools available to recall necessary information
  • Documents all customer correspondence and maintains confidential records of patient information
  • Required to meet all company set metrics
  • First call resolution mind set

Requirements:

  • 6+ months previous call center experience or customer service
  • Multitasking capability with superb time management
  • Excellent verbal and written communication, active listening, and the ability to express information clearly
  • Patience, empathy, and the ability to handle difficult customers professionally
  • Basic computer skills and ability to navigate phone systems and software
  • Experience with De-escalations
  • High school diploma or up to 1 year equivalent experience

Nice to have:

  • Experience with accident and health and whole life insurance
  • Claims experience
  • Familiar with Medical terminology
  • Working knowledge of problem solving and decision making skills
What we offer:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
March 25, 2026

Expiration:
April 03, 2026

Employment Type:
Fulltime
Work Type:
Hybrid work
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