About The Position
Behavioral Health Customer Service Representatives (CSR) provide advocate care to assist members with a clear path to care, claims understanding and resolution, and educate members with online resources. The role guides members through their plan of benefits, Aetna policy and procedures, and utilizes knowledge of resources to comply with regulatory guidelines. This position involves creating an empathetic connection with members by understanding and engaging them to champion for their best health. It requires taking accountability to fully understand member needs by building a trusting and caring relationship, and anticipating customer needs by answering unasked questions. Responsibilities also include performing reviews of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible, performing financial data maintenance as necessary, and explaining member's rights and responsibilities in accordance with the contract.
Requirements
- 1+ years of experience in a healthcare, call center environment.
- Experience using Microsoft Office products’ specifically Excel, Outlook, and Word.
- Must have a quiet/secure workspace in your home.
- Recommended Technical requirements when obtaining your own residential internet service: Select an internet service that is either broadband or fiber (e.g., Verizon Fios, Comcast).
- Select a minimum of 25mbps/3mbps internet speed.
- A hardwired connection is required (ethernet connection); a wireless connection will introduce the risk of performance degradation.
- Consider the internet usage of others in the household during your scheduled working hours; you may need to obtain a higher speed internet connection so your ability to perform your work is not affected.
Nice To Haves
- Previous Behavioral Health, Medical, or Insurance background.
- Experience working from home in a remote role.
Responsibilities
- Creates an empathetic connection with our members by understanding and engaging the member to the fullest to champion for our members' best health.
- Taking accountability to fully understand the member’s needs by building a trusting and caring relationship with the member.
- Anticipates customer needs by answering unasked questions.
- Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.
- Performs financial data maintenance as necessary.
- Explains member's rights and responsibilities in accordance with contract.
Benefits
- medical coverage
- dental coverage
- vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
- CVS Health bonus, commission or short-term incentive program
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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
