Job Summary

As a CVS Health Care Customer Service Representative, you will be the first point of contact for our valued customers, assisting them with inquiries related to their health care plans, prescription benefits, claims processing, and other services. This remote role requires strong communication skills, empathy, and a commitment to delivering outstanding customer experiences. You will play a vital role in supporting our mission to help people on their path to better health.

Key Responsibilities

• Respond promptly and professionally to inbound customer inquiries via phone, chat, or email.

• Assist members with questions regarding pharmacy benefits, prior authorizations, prescription refills, and claim statuses.

• Accurately document customer interactions and update account information in the CRM system.

• Resolve customer concerns efficiently while maintaining compliance with company policies and HIPAA regulations.

• Escalate unresolved or complex issues to the appropriate department.

• Educate members about CVS Health programs, tools, and digital services for self-service options.

• Meet or exceed quality, performance, and customer satisfaction metrics.

Required Skills and Qualifications

• High School Diploma or GED required; Associates or Bachelors degree preferred.

• Exceptional verbal and written communication skills.

• Strong listening, interpersonal, and problem-solving abilities.

• Computer literacy with the ability to navigate multiple systems simultaneously.

• High attention to detail and accuracy.

• Ability to work independently in a remote environment.

Experience

• Minimum of 1 year of experience in a customer service or call center role, preferably in the healthcare, insurance, or pharmacy industry.

• Experience working with healthcare management systems (e.g., CRM, insurance databases) is a plus.

Working Hours

• Flexible scheduling available: morning, evening, and weekend shifts.

• Full-Time: 40 hours per week.

• Part-Time roles also available (minimum 20 hours/week).

• Some holidays may be required depending on business needs.

Knowledge, Skills, and Abilities

• Knowledge of health insurance plans and terminology (e.g., copays, deductibles, prior authorization).

• Ability to remain calm and professional in stressful situations.

• Strong organizational skills with the ability to multitask in a high-volume environment.

• Demonstrated ability to learn new processes and systems quickly.

• Bilingual candidates (especially Spanish-English) are encouraged to apply.

Benefits

• Competitive hourly wage plus performance bonuses.

• Health, dental, and vision insurance.

• Paid time off (PTO), holidays, and sick leave.

• 401(k) plan with company match.

• Tuition reimbursement and career development programs.

• Employee wellness programs and telehealth services.

• Exclusive CVS employee discounts.

Why Join CVS Health?

CVS Health is a purpose-driven company dedicated to improving the lives of millions. When you join our team, you become part of a culture built on compassion, innovation, and integrity. As one of the nations leading health solutions companies, we empower our employees to grow professionally, make a difference, and contribute to transforming the future of healthcare.

How to Apply

Ready to start your career with CVS Health?
Click the Apply Now button on our careers page, search for Customer Service Representative – Remote, and submit your application online. Be sure to upload your updated resume and complete the required assessments.