Customer Service Representative, Medical Review/Accident & Health

CVS Health • Franklin, TN

4d • $17 - $28

About The Position

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 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

Nice To Haves

• Experience with accident and health and whole life insurance
• Claims experience
• Familiar with Medical terminology
• Working knowledge of problem solving and decision making skills

Responsibilities

• 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.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED