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 Summary: CVS Aetna has an opportunity available for a full-time Customer Service Representative aligned with the Behavioral Health team. This role provides advocate care to assist the member with a clear path to care, claims understanding/resolution, and member education around online resources. The Customer Service Representative guides the members through their members’ benefit plans and Aetna policy/procedures. They will also be expected to have knowledge of regulatory guidelines governing these resources. The Customer Service Representative position is ideal for someone with strong interpersonal skills, a passion for mental wellness advocacy, and is comfortable working with digital platforms in a fast-paced and emotionally sensitive setting. Key Responsibilities: The Customer Service Representative's responsibilities include (but are not limited to) the following: - Takes inbound calls from members and determines the quickest, most effective ways to answer member questions - Creates an emotional connection with members by understanding and engaging them to champion their best health - er records within the overall member management system - Provides introductory information and connects members with additional and appropriate benefits/external resources - Performs a review of members’ claim history to ensure accurate tracking of benefit maximums, including deductible and coinsurance levels - Explains members’ rights and responsibilities in accordance with our plan sponsors’ contracts - Sends outbound e-mails to members where and as needed - Supports members with troubleshooting and deescalating where needed - Escalates queries and concerns when it is deemed necessary - Ensures that members are satisfied with products/services by handling complaints and inquiries - Works with the customer service team to share solutions and processes - Embodies the CVS Core values in each interaction Required Qualifications: - 1-3 of call center and/or customer service experience - Basic computer knowledge and technical skills to use IP phones, customer records management, word processing, database, and e-mail/chat programs - A private and confidential workspace free from distractions - A hardwired connection is required (i.e., an Ethernet connection) - Time management skills to promptly respond to e-mails, call, and chat messages - Active listening skills to effectively handle members who may be upset Preferred Qualifications: - A mental health or human services background. - One to three years of healthcare experience. - Bilingual or multilingual skills - Experience working from home in a remote role. Educational Requirements: - High school diploma or equivalent required. - Associates degree preferred. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $31.30 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. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

• Guide customers and junior level staff to TD resources, ensuring internal and external customers have a consistent and positive pre-sale experience • Respond to inquiries and issues requiring in depth research and follow through • Identify and implement improvements of internal and customer facing processes that enhance the efficiency of order management and operational functions • Monitor the effectiveness of implemented changes and adjust strategies as needed to ensure continuous improvement. • Provide training, coaching, and support to internal teams to improve their ability to utilize new tools, systems, and processes effectively. • Represent the Customer Experience Team and their customers during Go To Market and other Product related meetings and activities • Submit completed quotes and bids to federally and/or state funded agencies • Develop and maintain internal resources, tools, and best practices for use by the order management and other customer facing teams to ensure consistency and accuracy in operations. • With the Customer Experience Manager, track and provide report outs on customer and internal customer trends and needs • Conduct regular reviews of current processes, systems, and performance metrics to identify areas for improvement and propose actionable solutions. • Review and update departmental forms and internal process documentation • Collaborate with cross-functional teams to streamline processes, optimize workflows, and improve overall system efficiency and customer experience. • Resolve escalated order management issues, assist with order management quality assurance initiatives and monitor backorders • Foster customer relationships, gather and track feedback and recommend improvements to the order management experience with a “customer first” approach • Perform various other duties as assigned

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Case Management Specialist PRIMARY PURPOSE: To access and assign workers compensation, disability and liability cases applying current policies and procedures per state workers compensation laws; and to increase efficiency of operation by providing general customer support duties and supporting the medical staff in a team environment. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - ​Accesses and assigns cases for medical case management, utilization review and clinical consultation. - Provides accurate information to callers based on customer requests; triages telephone calls between utilization review, clinical consultation and telephonic case managers. - Enters new claims data into the claims management system accurately; maintains data integrity. - Supports clinical staff through the completion of components of the case management and utilization review process. - Schedules diagnostic tests and physician appointments as assigned. - Provides channeling services for injured workers, employers and claims examiners by directing into PPO network for treatment. - Gathers statistics for record keeping and provides reports as required. - Ensures by confirmation that fax forms and filings required by regulatory agencies have been received; distributes, faxes, mails and copies incoming and outgoing correspondence. ​ Education & Licensing Associate's degree or two (2) years of college preferred. Experience One (1) year of administrative experience required. Customer service experience in a medical field preferred. Worker's compensation, disability and/or liability claims processing experience preferred. Skills & Knowledge - Knowledge of medical and insurance terms - Knowledge of ICD 9 and CPT coding systems - Excellent oral and written communication, including presentation skills - PC literate, including Microsoft Office products - Analytical and interpretive skills - Strong organizational skills; detail-oriented - Good interpersonal skills - Ability to work in a team environment - Ability to meet or exceed Performance Competencies TAKING CARE OF YOU BY - Offering a blended work environment. - Supporting meaningful work that promotes critical thinking and problem solving. - Providing on-going learning and professional growth opportunities. - Promoting a strong team environment and a culture of support. - Recognizing your successes and celebrating your achievements. - Thrives when everyone is working towards the same vision/goals. - We offer a diverse and comprehensive benefits package including: - Three Medical, and two dental plans to choose from. - Tuition reimbursement eligible. - 401K plan that matches 50% on every $ you put in up to the first 6% you save. - 4 weeks PTO your first full year. ​NEXT STEPS If your application is selected to advance to the next round, a recruiter will be in touch. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

• Responsible for receiving calls from child support client stakeholders in accordance with Standard Operating Procedures and contractual obligations • Categorizing all calls received in one of the categories provided • Record any abusive and/or extraordinary calls • Responsible for other duties as assigned • Provide accurate, valid, and complete information • Resolve customer complaints, provide appropriate solutions and alternatives • Document customer interactions • Thoroughly and efficiently gather customer information, assess, and fulfill customer needs and educate customers where applicable • Maintain a general understanding of policies and procedures