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
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

1-3 years 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
1-3 years of healthcare experience (preferred)
Background in mental health or human services (preferred)
Bilingual or multilingual skills (preferred)
Experience working from home in a remote role (preferred)

Customer Service Representative – Behavioral Health

Key skills