Remote Customer Care Specialist

Join our dedicated team at CVS Wellbeing as a Remote Customer Care Specialist! We're looking for compassionate and skilled individuals to deliver exceptional support to our members. This is a fantastic opportunity to make a real difference in people's lives while enjoying the flexibility of a remote work environment. We offer a competitive salary and a comprehensive benefits package. If you're passionate about providing outstanding service and thrive in a dynamic environment, we encourage you to apply!

Position Outline

As a Remote Customer Care Specialist, you'll be the voice of Aeetna, directly impacting our members' experience through phone, web, and written communication. You'll expertly guide members through their benefits, policies, and resources, ensuring they receive the support they need to navigate their healthcare journey. This role requires flexibility, as we operate a 24/7 inbound call center, including weekends and holidays. The ability to work any shift is essential.

Key Responsibilities

• Respond to and resolve member inquiries via phone, email, and written correspondence.
• Escalate complex issues to appropriate staff.
• Guide members through their benefits, policies, and resources, ensuring compliance with regulations.
• Build rapport with members, understanding their needs and providing personalized support.
• Proactively anticipate member needs and provide relevant information.
• Utilize customer service best practices to resolve member issues effectively.
• Process requests for guarantees, new case handoffs, reviews, and complaints.
• Educate providers on self-service options and assist with credentialing.
• Respond to inquiries from Aeetna's Regulation Record Center regarding litigation and claims.
• Assist with the development of complaint trend reports and member satisfaction surveys.
• Determine clinical needs, eligibility, and benefits coverage.
• Handle requests for pre-approvals not managed by Clinical Case Management.
• Review member guarantee history to ensure accurate tracking of benefits and costs.
• Perform financial data support as needed.
• Create reports and calculations using relevant systems and tools.

Required Skills & Qualifications

• Proven experience in a customer service environment (call center or retail preferred).
• Ability to multitask and prioritize effectively.
• Strong understanding of medical terminology.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Word and Excel.
• Commitment to accuracy and attention to detail.
• Strong problem-solving and critical thinking abilities.

Compensation: This position offers a competitive hourly rate, with the final compensation determined by experience, education, location, and other factors. We offer a comprehensive benefits package including medical, dental, vision, 401(k), employee stock purchase plan, life insurance, disability benefits, and various wellness programs. We also provide paid time off, holidays, and other time-off benefits in accordance with state and company policies.

We encourage you to apply, even if you don't meet every qualification! We're looking for enthusiastic and dedicated individuals to join our team.