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About the Role
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.
Responsibilities
- 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.
- 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.
Requirements
- 1-3 years of call center and/or customer service experience.
- 1-3 years of healthcare and/ or medical insurance 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.
Skills
- Interpersonal skills
- Mental wellness advocacy
- Digital platforms
- Time management
- Active listening
Location
- Remote
Work Type
- Full-time
Experience Level
- 1-3 years
Education Level
- High school diploma or equivalent
- Associate's degree preferred
Salary/Compensations
- $17.00 - $31.30 per hour
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
About the Company
- 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.
- 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.
Equal Opportunity
- Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.