Healthcare Plan Support Specialist

CVS Health Corporation; Phoenix (AZ); On-site; USD 23,000 - 43,000; Full time

Job summary

CVS Health Corporation invites applications for a Customer Service Representative to support Aetna/Mercy Care with inquiries via phone, web, or mail. You will educate members on plan details, resolve issues, and document interactions in a compliant manner.

Requires 1 year in a call center, MS Office skills, and availability to work in the Arizona Time Zone. This is a full-time role with comprehensive benefits and a focus on compassionate service.

Qualifications

• At least 1 year of experience in a call center or high-volume environment.
• Proficient with Microsoft Office (Word, Excel, PowerPoint, Outlook).
• Ability to support Arizona Time Zone.

Responsibilities

• Engage, consult, and educate members to guide care paths.
• Answer questions and resolve issues from members, providers, and plan sponsors.
• Document and track contacts and outcomes.
• Explain benefits and policy details while following regulatory guidelines.
• Handle appeals and pre-authorizations not managed by Clinical Claim Management.
• Review member claim history to verify benefit maximums and coinsurance.

Skills

Call center experience

Communication skills

Empathy

Organizational skills

Time management

Education

High school diploma or GED

Tools

Microsoft Office

Job description

CVS Health Corporation invites applications for a Customer Service Representative to support Aetna/Mercy Care with inquiries via phone, web, or mail. You will educate members on plan details, resolve issues, and document interactions in a compliant manner.

Requires 1 year in a call center, MS Office skills, and availability to work in the Arizona Time Zone. This is a full-time role with comprehensive benefits and a focus on compassionate service.