Remote: Senior Claim Benefit Specialist (Meritain Health) CVS

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. Starting hourly rate $15.00, with unlimited bi-weekly commission potential. 10 days of required paid training (Monday-Friday, 8AM-4:30PM CST.) Call center hours of operation are Monday-Sunday 7AM – 7PM, actual shift will be determined at time of hire. Competitive benefits, PTO, tuition reimbursement, and more! How will this role have an impact? At Signify Health, we value and seek exceptional thinkers with the heart and humility to match. Join us on a mission to improve lives and make a lasting difference. As a Member Engagement Coordinator you will contact members of various Medicare Advantage and Medicaid health plans by phone to offer, explain, and schedule a free in-home or virtual healthcare evaluation. You will work diligently to meet department productivity, quality, and customer service goals. This role will report to a Member Engagement Manager. What will you do? Make an average of 50 outbound calls per hour placed by an automatic dialer system to offer, explain, and schedule a free in-home or virtual health evaluation with a provider Follow 20+ approved scripts, ensure members understand and are comfortable with the terms, and respond to rebuttals persuasively and with professional courtesy Present a positive, professional, and high energy approach to clients, health plan members, and team members Meet daily goals set by the department (i.e., 300-400 outbound dials per day, 25 appointments set per day, shift and attendance policy adherence, quality targets, etc.) in an office or remote environment Adjust, reschedule, and cancel appointments with both members and contracted providers, as requested Monitor performance results including appointments, calls, handle time, and productivity using designated reporting systems Report member complaints and escalations immediately to Member Engagement Managers Participate in peer side-by-side coaching as needed Follow HIPAA and other security and privacy guidelines when handling protected health information accessed during normal work activities We are looking for someone with: A High School Diploma or equivalent is preferred 1+ year call center experience OR 2+ years general work experience required Previous outbound call center or high volume experience working in a metrics driven environment, with an auto dialer, and/or using scripts is preferred A desire to work in an efficient, results-oriented outbound call center environment Persuasive with the ability to rebuttal while treating all health plan members with professional courtesy Good communication skills, friendly and conversational Ability to adhere to a fixed daily schedule, including start, breaks, lunch, and end times Strong computer skills and the ability to use multiple systems at the same time, while making calls Benefits: Medical, Dental and Vision plans, Insurance starts the 1st of each month after the start date Bi-weekly pay with monthly commission bonus potential 401K, employee stock purchase program and tuition reimbursement Employee discount programs Work From Home Requirements: To qualify, you must have verified and reliable internet service with 10MB upload/download ability available in your home. The company will provide equipment (keyboard, monitor, computer, headset, etc.). All applicants must provide their own workspace furniture and ensure a quiet workspace. Conditions of Employment: Successful completion of background check is required for this position. Location: This remote role is located in the Continental United States and requires candidates to be located within the Continental United States. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $15.00 – $26.93 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. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This part‑time position is eligible for a range of benefits and programs that support the physical, emotional, and financial well‑being of colleagues. Depending on hours worked and eligibility, the benefits for this position include dental, vision, wellness resources, employee discounts, access to certain voluntary benefits, and other programs. Additional details about available benefits are provided during the application process and on Benefits Moments. This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr