Customer Service Representative, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Not provided

Salary:

17.00 - 28.46 USD / Hour

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Job Description:

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Job Responsibility:

Work in front of a computer for approximately 8 hours speaking with members on the phone with little time in between calls during your scheduled phone hours
Listen to the member’s needs and provide direction on how to get them the care they may need
Create an emotional connection with our members by understanding and engaging the member to the fullest
Fully understand the member’s needs by building a trusting and caring relationship with the member
Provide the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
Educates and assists customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company
Utilizes all relevant information to effectively influence member engagement
Provides education to members to support them in managing their health
Guides members to the appropriate health resource
Offers alternatives where appropriate
Acts with the best interest of customer in mind and central to all interactions
Documents and tracks all contacts, events, and outcomes with members using appropriate systems and processes
Takes immediate action when confronted with a problem or made aware of a situation
Resolves issues without or with limited management intervention
Uses customer service threshold framework to make financial decisions to resolve member issues
Responds quickly to meet customer needs and resolve problems while avoiding over-committing
Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility
Processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals
Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded
Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction
Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service
Partners with other departments to deliver client specific presentations
Works collaboratively with colleagues to deliver the best customer experience
Appropriately transitions conversations to explore possibilities for extending customer interactions
Collaborates with colleagues and co-workers to deliver a world class customer experience
Serves as SME providing technical assistance when needed on call related issues, products, and/or system applications delivery matters
May participate in preparation and presentation of client specific presentations
May track and trend data
Coaches, trains and assists in the development of call center staff, as required
Participates in and/or leads special projects/initiatives addressing service issues, as necessary
Provides technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools as needed

Requirements:

Must live in and work Eastern Standard Time Zone
Must be flexible to work an 8 hour shift between 8am and 8pm EST
Customer Service experience in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate
1+ year of Microsoft Office Suite Experience
Must have experience working multiple screens and applications

Nice to have:

Effective organizational skills and ability to manage multiple tasks
Effective communication skills, both verbal and written

What we offer:

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

Additional Information:

Job Posted:
April 25, 2025

Expiration:
May 05, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Customer Service Representative