Medicare Service Advocate

CVS Health•Atlanta, GA

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. We are currently recruiting top talent for our Service Advocate role in our Medicare Stars Member Advocacy Center. Aetna Medicare’s Member Advocacy Center engages with our members to provide innovative, proactive, and compassionate solutions that exceed our member’s expectations. In this role, you will connect with members through many channels including outbound and inbound calls, video conferencing and SMS to answer unasked questions and resolve issues. Our service advocates have a high degree of empathy and patience. This position also requires performing a review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible and educating the member on their plan of benefits based on the campaign. The service advocate will be using several computer-based programs to service the members' needs and will need to be able to work in a metric-based production environment. We are the knowledgeable, trusted, advocates for our members. The key to our success is our people. We encourage bilingual applicants to apply.

Requirements

Ability to creatively solve members’ problems and have desire to help and advocate for them
Problem solving with demonstrated ownership qualities
Demonstrated empathy, compassion and listening skills
Window based application knowledge
High School Diploma or GED

Nice To Haves

Proven leadership skills
Demonstrate ability to de-escalate situations
Effective communication and documentation skills
Ability to quickly learn new skills and apply them
Demonstrated skills to multitask and problem solve
Healthcare and medical terminology knowledge
Medical billing and claims process experience
Bilingual preferred

Responsibilities

Educates plan benefits, answers questions, and resolves issues based on campaign outreach
Documents and tracks contacts with members
Educates members on our self-service options
Follows campaign guidelines for exceptional service
Exceeds member expectations
Ensures that every caller is treated with respect, kindness and all questions are thoroughly answered
Respond to inquiries from our Medicare Advantage members
Connects with members to diminish service disruption and educate members on plans
Takes ownership and follows through on commitments
Create lasting relationships with our members
Work in a team and production-based environment to create world class service
Ability to navigate multiple systems
Acts as an advocate for our members
Performing a review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
Educating the member on their plan of benefits based on the campaign