[Remote] Customer Service Representative - Behavioral Health (Shift: 10:30AM - 7:00PM EST)

Note: The job is a remote job and is open to candidates in USA. CVS Health is committed to building a world of health around every individual and is seeking a full-time Customer Service Representative for their Behavioral Health team. This role involves providing advocate care to members, assisting with claims understanding, and guiding them through their benefit plans while ensuring a compassionate and effective service experience.

Responsibilities

• Takes inbound calls from members and determines the quickest, most effective ways to answer member questions
• Creates an emotional connection with members by understanding and engaging them to champion their best health
• Maintains accurate records within the overall member management system
• Provides introductory information and connects members with additional and appropriate benefits/external resources
• Performs a review of members’ claim history to ensure accurate tracking of benefit maximums, including deductible and coinsurance levels
• Explains members’ rights and responsibilities in accordance with our plan sponsors’ contracts
• Sends outbound e-mails to members where and as needed
• Supports members with troubleshooting and deescalating where needed
• Escalates queries and concerns when it is deemed necessary
• Ensures that members are satisfied with products/services by handling complaints and inquiries
• Works with the customer service team to share solutions and processes
• Embodies the CVS Core values in each interaction

Skills

• 1-3 of call center and/or customer service experience
• Basic computer knowledge and technical skills to use IP phones, customer records management, word processing, database, and e-mail/chat programs
• A private and confidential workspace free from distractions
• A hardwired connection is required (i.e., an Ethernet connection)
• Time management skills to promptly respond to e-mails, call, and chat messages
• Active listening skills to effectively handle members who may be upset
• A mental health or human services background
• One to three years of healthcare experience
• Bilingual or multilingual skills
• Experience working from home in a remote role

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources

Company Overview

• CVS Health is a health solutions company that provides an integrated healthcare services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode Island, USA, with a workforce of 10001+ employees. Its website is https://www.cvshealth.com/.

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