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Customer Service Representative Β– Work From Home ( CVS Health REMOTE WORK) ID-1360

We are hiring a customer service representative to manage customer queries and complaints. You will also be asked to process orders, modifications, and escalate complaints across a number of communication channels. To do well in this role you need to be able to remain calm when customers are frustrated and have experience working with computers.
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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 Β— with heart at its center Β— our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work BehaviorsΒ™ 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.

This position is work from home and you must live in the State of Oklahoma.

Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST.

After training, the permanent schedule is an Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CST.

Responsibilities:

Maintaining a positive, empathetic, and professional attitude toward customers at all times.

Responding promptly to customer inquiries.

Communicating with customers through various channels.

Acknowledging and resolving customer complaints.

Knowing our products inside and out so that you can answer questions.

Processing orders, forms, applications, and requests.

Keeping records of customer interactions, transactions, comments, and complaints.

Communicating and coordinating with colleagues as necessary.

Providing feedback on the efficiency of the customer service process.

Managing a team of junior customer service representatives.

Position Summary

Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Provide excellent customer services for high volume in bound provider calls for the Claims Inquiry/Claims Research team. Extensive claims research on multiple platforms to assist providers with payment questions.

Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc. Uses customer service threshold framework to make financial decisions to resolve member issues. Explains member's rights and responsibilities in accordance with contract.

Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system .

Educates & assists providers on our self-service options. Assists providers with credentialing and re-credentialing and contracting questions and issues.

Assists in compiling claim data for customer audits. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.

Required Qualifications

MUST live in the state of Oklahoma full-time

Familiarity with Microsoft Office products

Experience in highly transactional call center environment

Excellent customer service and critical thinking

High speed internet access (25 mbps or higher) and consistent connection

Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6 Β½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable.

Education

High School diploma or GED equivalent.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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