Description
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, and prioritize safety and quality in everything we do.
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 members with a clear path to care, claims understanding and resolution, and member education around online resources. The Customer Service Representative guides members through their benefit plans and Aetna policy and procedures, while having knowledge of regulatory guidelines governing these resources.
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 and 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 plan sponsors' contracts.
- Sends outbound emails to members where and as needed.
- Supports members with troubleshooting and de-escalating where needed.
- Escalates queries and concerns when necessary.
- Ensures that members are satisfied with products and 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 email/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 emails, calls, and chat messages.
- Active listening skills to effectively handle members who may be upset.
Preferred Qualifications:
- Background in mental health or human services.
- Bilingual or multilingual skills.
- Experience working from home in a remote role.
- Associate's degree.
Education:
- A high school diploma or equivalent.
Schedule:
- Monday-Friday, 10:00 AM-6:30 PM EST for 8 weeks (training).
- Available work schedules: 8am-8pm EST, shift will be assigned after offer and subject to change at least once a year.
Pay Range: $17.00 - $31.30
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.