[Hiring] Senior Service Advocate @CVS Health

Role Description

The Medicare Individual Customer Service Representative serves as the Single Point of Contact for member service inquiries and requests received by telephone. The role supports Individual Medicare members by listening carefully, asking the right questions, and resolving issues through accurate research, documentation, and follow-through. This position uses multiple systems to consult, educate, and guide members based on their individual needs.

• Handle inbound member calls and serve as the primary contact for service-related questions, issues, and requests.
• Verify member information, gather details, and accurately document interactions and outcomes in required systems.
• Research and resolve concerns by navigating multiple tools, policies, and resources to determine next best steps.
• Educate members on benefits, coverage-related topics, and available resources using clear, respectful, plain language.
• Support members who raise medical concerns by asking clarifying questions, following approved processes, and connecting them to the appropriate resources when needed.
• Manage multiple tasks during and after calls (notes, follow-ups, case routing, and updates) while maintaining quality and productivity expectations.
• De-escalate difficult calls by remaining calm, showing empathy, and working toward resolution and member satisfaction.
• Meet or exceed performance standards related to quality, timeliness, and overall service experience.
• Collaborate with internal partners as needed to resolve member issues and close the loop on commitments.

Qualifications

• 1+ years of customer service experience.
• Must reside in EST/CST time zone.
• Ability to build trusting relationships by taking accountability to fully understand the member’s needs.
• Ability to multitask and handle multiple functions and/or multiple products while maintaining and/or exceeding performance standards.
• Demonstrates professionalism and presents a positive image when interacting with members and constituents.
• Demonstrates strong member focus and utilizes all available resources to ensure prompt member satisfaction.
• Demonstrates functional expertise and leadership ability.
• Strong communication skills.

Requirements

• Microsoft Office experience.
• 1+ year of Medicare Service experience.
• High School or GED equivalent.

Benefits

• Comprehensive and competitive mix of pay and benefits.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.