About The Position
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. 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.
Requirements
- 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
Nice To Haves
- 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.
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
- Updates member 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
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
