Customer Service – CVS Remote Jobs

Job Type: Customer Service from home
Location: New Jersey work from home
Company: CVS Health

Responsibilities:

• Answers questions and solves problems that members, providers, and plan sponsors call or write about. assigns any extra work that comes up to the right people.
• Provide great customer service for the Claims Inquiry/Claims Research team’s large number of calls from providers. Extensive research on claims on multiple platforms to help providers with questions about payment.
• Gives the customer information to answer questions they didn’t know to ask, such as additional plan details, details about the benefits plan, member self-service tools, etc. Uses a customer service threshold framework to make financial decisions to solve member problems. Describes the member’s rights and duties based on the contract.
• Uses the target system to handle claim referrals, new claim handoffs, nurse reviews, member/provider complaints, grievances, and member appeals.
• Helps providers learn about and use our self-service options. Helps providers with questions about credentialing, re-credentialing, and contracts.
• Helps put together claim information for customer audits. Finds out if a member needs medical care, which coverage rules apply, and if the member is eligible for the plan based on incoming mail and internal referrals.

Pay Range

Average pay for this job is between $17.00 and $27.90 per hour.

Please keep in mind that this range is the pay range for all jobs in the same job grade as this position. The actual salary offer will depend on a lot of things, like where the job is.

Requirements:

• Knowing how to use Microsoft Office programs
• High speed access to the internet (25 mbps)
• Is your router in a place where you could set up a direct connection (NOT WI-FI) and work? (ethernet cord directly from computer to router). We give you an ethernet cable that is 6 feet long. If the distance is longer, you will need to bring your own ethernet cable.

Ideal Qualifications: Claims and knowledge of how to code

Education: Graduation from high school or a GED equivalent.