Customer Service Consultant

CVS Health • Washington, DC • 3w ago

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

The Customer Service Consultant handles escalated customer service inquiries and issues for clients experiencing claim or customer service problems. Prepares claim reviews and applies contracted rates in accordance with processing guidelines. Administers training, coaching, and resolutions for complex customer service issues.

What you will do

Process claims by leveraging provider contracts and processing guidelines.

Respond to inquiries from customers and other stakeholders regarding urgent processing, pricing disputes, and escalated issues.

Manages pending claims, claim follow-ups, and complex claim research scenarios, and serves as a technical resource on claim resolution.

Subject matter expert on workflows, policies, systems, and daily operations.

Keeps documentation of all constituent contacts, events, and outcomes in the appropriate systems.

Reviews systematic provider issues and educates providers on self-service options.

Takes direction to execute processes and responsibilities.

Responsible for delivering exceptional customer experiences by ensuring each interaction is professional, efficient, and customer-focused.

Required Qualifications

2+ years' experience in an office/corporate based work environment.

1+ years experience handling customer inquiries and correspondence.

Ability to work in the Eastern or Central time zone.

Familiarity with Microsoft Office applications.

Experience toggling multiple systems, dual screens, and using technology.

Experience working in a production based, fast paced environment.

Preferred Qualifications

Experience within the healthcare industry in a claims related role.

Demonstrated problem solving and decision making skills.

Ability to communicate clearly and effectively with leadership and customers.

Education

High school diploma or GED required.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/17/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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