This position is responsible for providing exemplary service to all customers, internal and external, to ensure a seamless review and resolution to all escalated concerns.
In this role as an Escalation Resolution Specialist, you will be responsible for:
-Escalated account review including proper billing and insurance processing (under both medical and pharmacy benefit)
- One call resolution; ability to assess and identify root cause and proceed with appropriate action to resolve matter at hand.
- Ability to de-escalate a situation and offer solutions to both the members and/or our internal partners.
- Ability to take ownership and prioritize escalated situations appropriately; ensure situation is cared for in a timely manner.
- Maintain and fulfill follow up commitments during the resolution process through completion.
- Provide feedback/trends on escalated issues in an attempt to minimize any negative impact on Brand or Customer Experience.
- Create and work various reports in Excel.
- May perform other duties and responsibilities as assigned.
- 12 months experience performing healthcare reimbursement, medical insurance billing or related work.
- 1+ years' experience working in a customer service related environment resolving escalated patient/customer issues.
- 1+ years' experience of Microsoft Office specifically intermediate to advanced Excel skills.
- Patient facing experience, including, but not limited to: excellent phone demeanor; patience and understanding; ability to avoid ambiguous language; projecting a positive and professional image
- Able to see the “big” picture and be future-thinking; while identifying trends and offering solutions.
Verifiable High School Diploma or GED required
It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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