Customer Service Representative - Behavioral Health

CVS Health is building a world of health around every individual, and they are seeking a full-time Customer Service Representative for the Behavioral Health team. This role involves providing advocate care to assist members with their benefit plans and Aetna policies, while also guiding them through claims understanding and online resources.

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
• Er 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

Requirements:

• 1-3 years of call center and/or customer service experience
• 1-3 years of healthcare and/ or medical insurance 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 high school diploma or equivalent
• Background in mental health or human services
• Bilingual or multilingual skills
• Experience working from home in a remote role
• Associates degree