Customer Service Representative-Behavioral Health

CVS Health

1d•Remote

About The Position

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 benefit plans and Aetna policy/procedures, and is expected to have knowledge of regulatory guidelines governing these resources. The 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.

Requirements

1-3 years 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.

Nice To Haves

1-3 years of healthcare experience.
Background in mental health or human services.
Bilingual or multilingual skills.
Experience working from home in a remote role.

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.
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.