Customer Service Representative – Behavioral Health

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Respond to incoming calls from members and identify the fastest, most efficient ways to address their inquiries.

• Establish an emotional rapport with members by actively engaging with them to promote their optimal health.

• Maintain accurate member records within the comprehensive member management system.

• Provide introductory information and link members to relevant benefits and external resources.

• Review members’ claims history to ensure precise monitoring of benefit limits, deductibles, and coinsurance levels.

• Clarify members’ rights and responsibilities as outlined in plan sponsors’ contracts.

• Send outbound emails to members as necessary.

• Assist members with troubleshooting and conflict resolution.

• Escalate inquiries and concerns when appropriate.

• Address complaints and inquiries to guarantee member satisfaction.

• Share solutions and procedures with the customer service team.

• Exemplify CVS Core values in every interaction.

⛳️ Requirements

• 1-3 years of experience in a call center or customer service setting.

• 1-3 years of experience in healthcare or medical insurance.

• Basic computer skills and technical proficiency to utilize IP phones, customer records management systems, word processing, databases, and email/chat applications.

• A private and confidential workspace that is free from distractions.

• A hardwired internet connection is mandatory (i.e., Ethernet connection).

• Strong time management skills to respond promptly to emails, calls, and chat messages.

• Active listening skills to effectively assist members who may be distressed.

• A high school diploma or equivalent is required.

• Availability to work between 8 AM - 8 PM EST post-training.

• Preferred: experience in mental health or human services.

• Preferred: bilingual or multilingual abilities.

• Preferred: prior experience in a remote working environment.

• Preferred: an associate degree.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base salary.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources that support physical, emotional, and financial well-being, based on eligibility.