Senior Customer Service Representative

CVS Health

21h • $19 - $39

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 Primary Job Duties & Responsibilities LATE SHIFT WEEKDAYS - must work till 8pm ET Handle customer service inquiries and problems via telephone, internet, or written correspondence are handled. Administers the healthcare benefits enrollment plan to guide customers through the application process and assist with required documentation. Interprets complex regulations such as the Affordable Care Act (ACA) and Health Insurance Portability and Accountability Act (HIPAA) for customers. Maintains a customer support and mentoring team to assist with customer inquiries and challenging situations. Manages the dissemination of information for customer coverage to ensure that customers understand benefits and have the ability to make informed decisions about health care. Monitors pending legislation, regulations, and compliance requirements for healthcare benefit plans to inform customers of new developments. Communicates changes in the health care benefits industry to expand the knowledge and skillset of supporting teams. Compares healthcare benefit options to determine the most appropriate plan based on customer needs and criteria. Organizes continuous learning and professional development opportunities to help customers stay updated on changes in the healthcare benefits industry. Conducts research on coverage verification to clarify what services and treatments are covered in addition to limitations or exclusions. Provide support to call center from 8am to 8pm EST as needed.

Requirements

• Must be able to work late shift until 8pm ET weekdays
• Must have 2+ years of GPS and QNXT experience
• Adept at problem solving and decision making skills
• Must have good knowledge of Medicare and Medicaid plans
• Must be able to pass qualification knowledge test
• High school diploma or 5+ years equivalent experience.

Nice To Haves

• Certified Customer Service Professional (CCSP) preferred.

Responsibilities

• Handle customer service inquiries and problems via telephone, internet, or written correspondence are handled.
• Administers the healthcare benefits enrollment plan to guide customers through the application process and assist with required documentation.
• Interprets complex regulations such as the Affordable Care Act (ACA) and Health Insurance Portability and Accountability Act (HIPAA) for customers.
• Maintains a customer support and mentoring team to assist with customer inquiries and challenging situations.
• Manages the dissemination of information for customer coverage to ensure that customers understand benefits and have the ability to make informed decisions about health care.
• Monitors pending legislation, regulations, and compliance requirements for healthcare benefit plans to inform customers of new developments.
• Communicates changes in the health care benefits industry to expand the knowledge and skillset of supporting teams.
• Compares healthcare benefit options to determine the most appropriate plan based on customer needs and criteria.
• Organizes continuous learning and professional development opportunities to help customers stay updated on changes in the healthcare benefits industry.
• Conducts research on coverage verification to clarify what services and treatments are covered in addition to limitations or exclusions.
• Provide support to call center from 8am to 8pm EST as needed.

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: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees