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 colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.

Position Summary To support the service and administration of Aetna's products to achieve profitable growth. This will be achieved through the development of strong relationships and execution of processes and workflows that effectively meet customer and plan sponsor needs.

Responsibilities

• Develops and executes customer product/plan administration.
• Meets with customers at least quarterly to discuss service levels and expectations, share process improvements, discuss operation of plans, identify gaps in service levels, determine root causes and develop solutions.
• Identifies customer specific service issues, identifies solutions and leads resolution of issues working with other areas to implement.
• Responds to customers' requests for claim analysis, plan design changes, and benefit questions and clarifications.
• Collaborates with account management team to achieve growth/renewal objectives; assists in preparation and delivery of renewal packages.
• Supports all plan administration activities, including installation, plan set-up, eligibility, billing and drafting by working proactively with support areas.
• Manages open enrollment activities.
• Promotes Navigator usage and implements strategies to increase usage for products.
• Notifies customers of Aetna policy changes, determining impact to customer and providing consultative support.
• Supports scheduling of customer meetings and preparation for these meetings.

Required Qualifications

• 1-3 years of experience in health care customer service.
• 3+ years of experience with Microsoft Office, including Outlook, Word, Excel, PowerPoint, and Teams.

Preferred Qualifications

• Prior health insurance industry-related experience working with complex accounts.
• Self-funded experience.
• Prior account management experience within the health insurance industry.
• Excellent customer service mindset.
• Strong critical thinking, organizational, and analytical skills.
• Effective communication skills, both verbal and written.
• Ability to learn quickly and work with minimal supervision.
• Confident and comfortable presenting information in a group setting.
• High school diploma or equivalent experience.

Anticipated Weekly Hours 40

Time Type Full time

Pay Range $43,888.00 - $85,068.00

Benefits 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.