Customer Service Representative – Behavioral Health

Job Description:

• Take inbound calls from members and determine the quickest, most effective ways to answer questions
• Create an emotional connection with members by understanding and engaging them to champion their best health
• Maintain member records within the overall member management system
• Provide introductory information and connect members with appropriate benefits and external resources
• Review members’ claim history to ensure accurate tracking of benefit maximums, deductibles, and coinsurance levels
• Explain members’ rights and responsibilities in accordance with plan sponsors’ contracts
• Send outbound emails to members as needed
• Support members with troubleshooting and de-escalation
• Escalate queries and concerns when necessary
• Handle complaints and inquiries to ensure member satisfaction
• Share solutions and processes with the customer service team
• Embody 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, calls, and chat messages
• Active listening skills to effectively handle members who may be upset
• High school diploma or equivalent
• Must be able to work between 8am-8pm EST post-training
• Preferred: background in mental health or human services
• Preferred: bilingual or multilingual skills
• Preferred: experience working from home in a remote role
• Preferred: associate degree

Benefits:

• CVS Health bonus, commission or short-term incentive program in addition to base pay
• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting physical, emotional, and financial well-being, based on eligibility

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