Experienced Remote Customer Service Representative – Medicaid Member and Provider Support Specialist Based in Virginia

Introduction to CVS Health and Our Mission

At CVS Health, we are driven by a singular purpose: to bring our heart to every moment of your health. This guiding principle shapes our commitment to delivering enhanced, human-centric healthcare in a rapidly changing world. Our brand, with heart at its center, sends a personal message that how we deliver our services is just as important as what we deliver. We strive to empower every colleague to feel valued 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 Overview

We are seeking an experienced and compassionate Remote Customer Service Representative to join our team as a Medicaid Member and Provider Support Specialist. As a key member of our customer service team, you will provide telephone assistance to Aetna Medicaid members and providers, addressing a wide range of inquiries, including eligibility, provider changes, and requests for ID cards. Your primary goal will be to deliver an exceptional experience to our callers every time, ensuring that their needs are met with empathy, understanding, and professionalism.

Key Responsibilities

• Answer incoming calls from members and providers, responding to inquiries regarding benefits, eligibility, services, prior authorization requirements, extra benefits, and programs.
• Provide accurate and timely information, resolving issues efficiently and effectively to ensure high customer satisfaction.
• Utilize strong customer service skills to de-escalate conflicts, address concerns, and provide personalized support to members and providers.
• Meet performance standards, attendance requirements, and call quality goals, consistently demonstrating a commitment to excellence in customer service.
• Collaborate with internal teams to resolve complex issues, ensure seamless communication, and promote a culture of teamwork and cooperation.

Requirements and Qualifications

To be successful in this role, you must possess the following essential qualifications:

• Must live within 50 miles of Richmond, VA, and be able to commute to the office when necessary due to prolonged technical problems.
• High school diploma or equivalent required; experience in a customer-facing role, preferably in a call center setting, is highly desirable.
• Ability to communicate effectively with members and providers, both orally and in written form, with strong active listening and problem-solving skills.
• Must be self-sufficient, able to work from home, and have a reliable high-speed internet connection via an ethernet cable (Wi-Fi is not permitted).
• Ability to work in a fast-paced environment, adapting to changing priorities and deadlines while maintaining a high level of productivity and attention to detail.

Preferred Qualifications

• Experience working remotely in a call center setting, with a proven track record of success in a similar role.
• Familiarity with Medicaid and Medicare, with a strong understanding of healthcare terminology and concepts.
• Previous experience with customer relationship management (CRM) software and other technology platforms used in customer service environments.

Skills and Competencies

To excel in this role, you will need to possess the following skills and competencies:

• Excellent communication and interpersonal skills, with the ability to build rapport with members and providers from diverse backgrounds.
• Strong problem-solving and analytical skills, with the ability to resolve complex issues and think critically.
• Empathy and compassion, with a genuine desire to help others and make a positive impact on their lives.
• Adaptability and flexibility, with the ability to work in a fast-paced environment and adapt to changing priorities and deadlines.
• Technical skills, with proficiency in CRM software, Microsoft Office, and other technology platforms used in customer service environments.

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to helping our colleagues grow and develop in their careers. As a Remote Customer Service Representative, you will have access to a range of training and development opportunities, including:

• Comprehensive training program, designed to equip you with the skills and knowledge needed to succeed in your role.
• Ongoing coaching and feedback, to help you continuously improve and develop your skills.
• Opportunities for advancement, with the potential to move into leadership roles or other areas of the business.
• Professional development courses, to help you enhance your skills and knowledge in areas such as customer service, communication, and leadership.

Work Environment and Company Culture

At CVS Health, we pride ourselves on our positive and inclusive work environment, with a strong focus on colleague engagement and well-being. As a Remote Customer Service Representative, you will be part of a dynamic and supportive team, with access to a range of benefits and perks, including:

• Competitive salary and benefits package, with a range of medical, dental, and vision benefits.
• 401(k) retirement savings plan, with company match.
• Employee Stock Purchase Plan, with the opportunity to purchase company stock at a discounted rate.
• Paid Time Off (PTO) and holidays, with a generous allowance for vacation and sick leave.
• Well-being programs and employee assistance, with access to counseling, fitness classes, and other resources to support your physical and mental health.

Compensation, Perks, and Benefits

The typical pay range for this role is $17.00 - $27.90 per hour, depending on experience and qualifications. In addition to your competitive salary, you will also be eligible for a range of benefits and perks, including:

• Medical, dental, and vision benefits, with a range of plan options to suit your needs.
• 401(k) retirement savings plan, with company match.
• Employee Stock Purchase Plan, with the opportunity to purchase company stock at a discounted rate.
• Paid Time Off (PTO) and holidays, with a generous allowance for vacation and sick leave.
• Well-being programs and employee assistance, with access to counseling, fitness classes, and other resources to support your physical and mental health.

Conclusion

If you are a motivated and compassionate individual with a passion for delivering exceptional customer service, we encourage you to apply for this exciting opportunity. As a Remote Customer Service Representative with CVS Health, you will be part of a dynamic and supportive team, with access to a range of benefits and perks, and the opportunity to make a positive impact on the lives of our members and providers. Don't miss out on this chance to join our team and take your career to the next level – apply today!

How to Apply

To apply for this role, please click on the "Apply To This Job" link and follow the instructions to submit your application. We look forward to hearing from you and exploring how you can contribute to our team's success.