Customer Service Representative

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: Customer Service Representative (CSR) takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Certified Pharmacy Technicians (CPhT) are preferred and compensated based experience.

CSR will also assist with other duties as needed to include but not limited to outbound calls, reviewing and processing prior authorizations (PA) for members’ prescriptions received via fax and electronic PA (ePA), and monitoring and responding to inquiries through department mailboxes. Additionally, the CSR will support other tasks as assigned by the leadership team. This is a fast-paced position that requires strong attention to detail and the ability to multi-task effectively.

Responsibilities % Time*:

Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards. 40%

Comply with departmental, company, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers. 40%

Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc). 10%

Identify and elevate clinical inquiries to the pharmacist team as appropriate. 10%

Required Qualifications:

• One year of Customer Service experience role handling and resolving a high volume of complex customer needs over the phone and demonstrated ability to deliver high-quality customer service
• Proficient PC skills, computer literacy, basic Google Suite skills, Windows-based applications like Windows, Microsoft Office, internet navigation, email applications and ability to navigate systems. Strong keyboard skills are essential.
• Must be able to multitask and utilize multiple system applications simultaneously
• Deliver confident and professional service to providers and internal partners
• Must be able to absorb presented information, display motivation, seek development and problem solve.

Education: High School Diploma or GED equivalent.

Preferred Qualifications:

• Active Arizona Pharmacy Technician License or Registered/Licensed Pharmacy Technician Trainee.
• Valid/Active PTCB Certification or NHA Certification.
• Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.
• Experience working in a retail, hospital, medical office, or pharmacy setting.

Remote Work Requirements:

• Prior remote work experience
• Ability to obtain high-speed internet and hardwire equipment to router/modem
• Distraction-free and private remote work environment required as well as reliable dependent care during working hours
• Ability to provide own transportation for instances where on-site support is required for employees located within 50 miles of a physical CVS Caremark location/center
• Ability to participate in classroom-style remote training sessions
• An understanding of the high level of conscientiousness, professionalism, and reliability that is required in a remote work environment

Work Schedule(s) available: We are seeking individuals open to working a 40 hour shift/schedule anytime Monday - Sunday between 8am-9pm EST. You will be given a set schedule after training based on business needs

Training: 5 weeks, Monday - Friday 7:00am - 3:30pm MST (100% attendance required)

Career Development Opportunities:
After training you will have the opportunity to earn a Certified Pharmacy Technician Certificate through an apprenticeship program.

The career path from Customer Service Representative to Clinical Support Technician includes:

• Active Pharmacy Technician License in the state of residence
• Certified Pharmacy Technician (CPhT) certification required
• A minimum tenure of 6 months in the Pharmacy Technician I role
• Consistently demonstrates strong problem-solving abilities, effective communication, and a thorough understanding of customer needs
• Demonstration of a strong desire to learn and grow in their role
• Meet “Exceptional” Expectations performance metrics for a minimum of 3 consecutive months (targets are subject to change with 30-day advance notice) for all job skills:
• Average Databases per Hour
• Average Handle Time
• Average Unavailable Time
• Quality Metrics
• Demonstrate proven reliability and satisfactory attendance

The progression path from Level I, Level II, and Level III positions within the Prior Authorization (PA) team is a structured path that encourages advocates to widen their knowledge base, take on more responsibility, demonstrate expertise, and reward team members for their proven success and dedication. Each role level builds upon the skills learned in the previous one, with the ultimate goal of enabling technicians to provide superior support and contribute to the overall success of the contact center.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.