Customer Service Representative – CVS Remote Jobs

Job Type: Customer Service Representative from home
Location: Florida work from home
Company: CVS Health

Responds to queries and handles problems depending on correspondence from members, suppliers, and plan sponsors. delegates rework that results to the proper staff. Provide top-notch customer service for the claims inquiry/research team’s large volume inbound provider calls.

Florida residency is required for this work, which pays $17.50 an hour.

Responsibilities:

• Extensive claims investigation across a number of platforms to help providers with payment-related queries.
• Gives the consumer pertinent information to address any unanswered queries, such as more specifics on the plan or benefits, member self-service resources, etc.
• When making financial decisions to address member difficulties, the customer service threshold framework is used. explains the contract-required obligations and rights of the member.
• Utilizes the target system to handle claim referrals, new claim handoffs, nurse reviews, complaints (from members and providers), grievances, and appeals (from members and providers).
• Explains our self-service alternatives and supports providers in using them.
• Helps providers with inquiries and challenges related to contracting, credentialing, and re-credentialing.
• Aids in gathering claim information for client audits.
• Verifies member plan eligibility in relation to inbound letters and internal referrals, as well as applicable coverage provisions and medical necessity.

Pay Scale

The usual pay scale for this position is as follows: 17.00 minimum; 27.90 maximum

Please remember that this range represents the salary range for every position in the job grade that this position belongs to. The location is just one of several variables that will be considered when determining the actual compensation offer.

Requirements:

Required credentials

• Knowledge of Microsoft Office programs
• A fast internet connection (25 mbps)
• Is your router situated somewhere you could set up and use a direct connection (NOT WiFi) to connect to? (ethernet cord directly from computer to router). We supply a 6-foot Ethernet cord; however, if the distance is greater, you must supply your own Ethernet cable.

Recommended Requirements

• Experience in call centers is preferred

Education

• Equivalent to a high school diploma