Customer Experience Representative Jobs

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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 Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience. Additional Responsibilities - Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication. - Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures. - Identifies and reports potential overpayments, underpayments, and other claim irregularities. - Performs claim rework calculations as needed. - Trains and mentors as needed to enhance team performance and technical proficiency. - Conducts outbound calls to obtain required information for claims or reconsideration requests. Required Qualifications - Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator. - Proven

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur

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. Job Purpose and Summary: At CVS Health, we are focused on transforming health care for our customers and making our company a great place to work. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. Within our Retail locations, we bring this promise to life with heart every day. Our Pharmacy Managers play a critical role in cultivating a culture of excellence in their respective pharmacy by acting as a role model for all, demonstrating genuine care, and setting the bar for their pharmacy team. As a Pharmacy Manager, you will lead and develop a pharmacy team that provides exceptional patient care by promoting best practices and leading through change while identifying and addressing performance opportunities. Pharmacy Managers support novel program awareness, onboard newly hired pharmacy team members, and recognize colleagues for their success. The Pharmacy Manager consistently exhibits best practices when working the bench, including quarterbacking the team, providing patients with meaningful counseling, and abiding by all legal and regulatory guidelines, amongst other required activities. The Pharmacy Manager is responsible for direct and effective management of their pharmacy team, including but not limited to: Living our pur