Customer Service Representative

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care 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™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Customer Service Representative  

• You will work in front of a computer for approximately 8 hours speaking with members on the phone with little time in between calls during your scheduled phone hours. 
• There is no standard scripting for this position.  You will listen to the member’s needs and provide direction on how to get them the care they may need. 
• We want you to create an emotional connection with our members by understanding and engaging the member to the fullest.  We want you to fully understand the member’s needs by building a trusting and caring relationship with the member.
• That includes going beyond the initial inquiry and asking the unasked question to the member to ensure you are providing the most complete customer service experience that you can for our members.
• Provide the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
• Educates and assists 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.).
• Utilizes all relevant information to effectively influence member engagement.
• Provides education to members to support them in managing their health.
• Guides 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.
• Takes immediate action when confronted with a problem or made aware of a situation.
• Resolves issues without or with limited management intervention.
• Uses customer service threshold framework to make financial decisions to resolve member issues.
• 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.

Required Qualifications:

• Customer Service experience in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.
• 1+ year of Microsoft