Customer Service Representative - Work from Home

Job Description
This is a Customer Service Work From Home Position at $17.50 per hour with a $1000 sign on bonus.

Handles provider customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature.

- Answers questions and resolves issues based on phone calls/letters from providers. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors.

- Explains member's benefits, rights and responsibilities in accordance with contract to our providers.

- Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues.

- Determines applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.

- Handles incoming status requests for appeals and pre-authorizations not handled by Clinical Claim Management.

- Performs review of member/provider claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.

- Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.

Required Qualifications
1-2 years Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.

• If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

• If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
High volume call center experience.

Education
High School Diploma or equivalent work experience.

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.