Customer Service New Business Operations

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: - Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health. - Anticipates customer needs. - 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 providers on our self-service options; Assists provider...