Experienced Customer Service Representative – EST Time Zone – Transforming Healthcare through Compassionate Support
About CVS Health
At CVS Health, we're on a mission to revolutionize the way healthcare is delivered. Our purpose is simple yet profound: Bringing our heart to every moment of your health. This guiding principle drives our commitment to delivering enhanced human-centric healthcare for a rapidly changing world. Anchored in our brand, with heart at its center, our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors
Our Heart At Work Behaviors support this purpose, empowering every CVS Health employee to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.Job Summary
We're seeking an experienced Customer Service Representative to join our team in the EST time zone. As a key member of our customer support team, you will be responsible for delivering exceptional service to our members, plan sponsors, and providers. If you're passionate about making a difference in people's lives and have a heart for customer service, we want to hear from you!Responsibilities
As a Customer Service Representative, you will be responsible for:- Answering questions and resolving issues as a single-point-of-contact based on phone calls from members, plan sponsors, and providers.
- Taking ownership of each customer contact to resolve their issues and connect them with additional services as appropriate.
- Taking immediate action when confronted with a problem or made aware of a situation.
- Seeking to understand the customer, including circumstances, problems, expectations, and needs.
- Asking probing questions to identify the underlying customer needs.
- Anticipating or identifying member needs beyond the initial inquiry by answering the unasked questions.
- Providing the customer with related information to answer the unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc.
- Providing customized interaction based on customer preference and individualized needs, creating an emotional connection with our members by understanding and engaging the member to the fullest.
- Fully understanding the member's needs by building a trusting and caring relationship with the member.
- Educating and assisting customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company (i.e., assistance with member self-service tools, Consultation Opportunities – Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc.).
- Utilizing all relevant information to effectively influence member engagement.
- Providing education to members to support them in managing their health.
- Guiding members to the appropriate health resource. Offers alternatives where appropriate.
- Acts with the best interest of customer in mind and central to all interactions.
- Documents and tracks all contacts, events, and outcomes with members using appropriate systems and processes.
- Uses customer service threshold framework to make financial decisions to resolve member issues.
- Resolves issues without or with limited management intervention.
- Responds quickly to meet customer needs and resolve problems while avoiding over-committing.
- Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility.
- Processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals.
- Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded.
- Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction.
- Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service.
- Partners with other departments to deliver client-specific presentations.
- Works collaboratively with colleagues to deliver the best customer experience.
- Appropriately transitions conversations to explore possibilities for extending customer interactions.
- Collaborates with colleagues and co-workers to deliver a world-class customer experience.
- Serves as SME providing technical assistance when needed on call-related issues, products, and/or system applications delivery matters.
- May participate in preparation and presentation of client-specific presentations.
- May track and trend data. Coaches, trains, and assists in the development of call center staff, as required.
- Participates in and/or leads special projects/initiatives addressing service issues, as necessary.
- Provides technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools as needed.
Qualifications
To be successful in this role, you will need:- Customer Service experience in a transaction-based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.
- Effective organizational skills and ability to manage multiple tasks.
- Effective communication skills, both verbal and written.
- High School Diploma Required.
Preferred Qualifications
While not required, the following qualifications would be beneficial:- Experience working in a healthcare or insurance environment.
- Knowledge of benefit plans and insurance products.
- Experience with customer relationship management (CRM) software.
- Ability to work in a fast-paced environment and adapt to changing priorities.
Compensation and Benefits
As a valued member of our team, you will enjoy a competitive compensation package, including:- A starting hourly rate of $17.50.
- A comprehensive benefits package, including medical, dental, and vision coverage.
- A 401(k) retirement savings plan and Employee Stock Purchase Plan.
- A fully-paid term life insurance plan and short-term and long-term disability benefits.
- Access to numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
- Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.
Career Growth Opportunities
At CVS Health, we're committed to helping our employees grow and develop their careers. As a Customer Service Representative, you will have opportunities to:- Develop your skills and knowledge in customer service, benefit plans, and insurance products.
- Take on additional responsibilities and leadership roles within the call center.
- Participate in special projects and initiatives to improve customer service and benefit plan understanding.
- Collaborate with other departments to deliver client-specific presentations and develop process improvements.