Dedicated Customer Service Representative – Work from Home Opportunity with CVS Health, Delivering Exceptional Patient Care and Support

Introduction to CVS Health At CVS Health, we are driven by a singular purpose: to bring our heart to every moment of your health. This guiding principle underscores our commitment to delivering human-centric healthcare that is both personal and transformative. As a leader in the healthcare industry, we recognize that the way we deliver our services is just as important as the services themselves. Our brand, with heart at its core, sends a powerful message about the value we place on empathy, compassion, and understanding in every interaction. Our Culture and Values Our 'Heart At Work Behaviors' are the foundation upon which our culture is built. We strive to empower every colleague to play a meaningful role in shaping our culture and driving innovation. By fostering an environment of inclusivity, respect, and open communication, we aim to make healthcare more accessible, affordable, and effective for all. If you are passionate about making a difference in the lives of others and are committed to excellence in everything you do, we invite you to join our team. Job Overview This is a unique opportunity to work from home as a Customer Service Representative with CVS Health, based in the state of Florida. As a key member of our team, you will be responsible for providing exceptional support to our members, providers, and plan sponsors, addressing their questions, concerns, and issues in a professional and empathetic manner. Your role will involve extensive claims research, education on self-service options, and assistance with credentialing and contracting questions, among other responsibilities. Key Responsibilities Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors, ensuring timely and effective resolution of all inquiries. Provide excellent customer service for high-volume inbound provider calls, conducting extensive claims research on multiple platforms to address payment questions and concerns. Offer related information to answer unasked questions, such as additional plan details, benefit plan details, and member self-service tools, to enhance the customer experience. Process claim referrals, new claim handoffs, nurse reviews, complaints, grievances, and appeals via our target system, ensuring accuracy and efficiency in all transactions. Educate and assist providers on our self-service options, and address questions and issues related to credentialing, re-credentialing, and contracting. Compile claim data for customer audits, determine medical necessity, and verify member plan eligibility, ensuring compliance with all relevant regulations and policies. Requirements and Qualifications To be successful in this role, you must meet the following requirements: Reside full-time in the state of Florida. Have familiarity with Microsoft Office products and experience in a highly transactional call center environment. Demonstrate excellent customer service and critical thinking skills, with the ability to work effectively in a fast-paced environment. Have high-speed internet access (25 mbps or higher) and a consistent connection, with a work location set up for a direct connection to the router. Be available to attend 4 weeks of virtual training between 8 am and 5 pm EST, with a permanent schedule of Monday to Friday, starting as early as 8 am EST and ending as late as 7 pm EST. Education A High School diploma or GED equivalent is required for this position. What We Offer In addition to a competitive salary range of $17.00 to $25.15 per hour, we offer a comprehensive benefits package, including: Medical, dental, and vision benefits. A 401(k) retirement savings plan and an Employee Stock Purchase Plan. A fully-paid term life insurance plan, short-term and long-term disability benefits, and 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 and Development At CVS Health, we are committed to the growth and development of our colleagues. We offer a range of training programs, mentorship opportunities, and career advancement possibilities to help you achieve your professional goals. Whether you are looking to develop new skills, take on new challenges, or advance in your career, we have the resources and support to help you succeed. Work Environment and Culture Our work environment is dynamic, supportive, and inclusive. We value diversity, equity, and inclusion, and strive to create a workplace where everyone feels valued, respected, and empowered to contribute. Our culture is built on a foundation of empathy, compassion, and kindness, and we are committed to making a positive impact in the lives of our colleagues, customers, and communities. Conclusion If you are a dedicated and compassionate individual who is passionate about delivering exceptional customer service and support, we invite you to join our team as a Customer Service Representative. With a competitive salary, comprehensive benefits, and opportunities for growth and development, this is an exciting opportunity to make a difference in the lives of others and advance your career in a dynamic and supportive environment. Apply now to take the first step towards a rewarding and challenging career with CVS Health.