Customer Service Representative- (Monday-Friday, 11:40am-8:10pm EST)

CVS Health•Work At Home-Illinois, NV

1d•$17 - $31

About The Position

CVS Aetna is hiring a full-time Customer Service Representative aligned with the Behavioral Health team. The role provides advocate care by helping members find a clear path to care, understand and resolve claims, and learn about online resources. The representative guides members through their benefit plans and Aetna policies and procedures, while applying knowledge of regulatory guidelines governing those resources. The role is suited to someone with strong interpersonal skills, an interest in mental wellness advocacy, and comfort using digital platforms in a fast-paced, emotionally sensitive setting. The position is scheduled Monday through Friday, 11:40 a.m. to 8:10 p.m. EST, for 40 hours per week. It requires a private, distraction-free workspace and a hardwired Ethernet connection. The stated pay range is $17.00–$31.30 per hour. The role is eligible for a CVS Health bonus, commission, or short-term incentive program, as well as a benefits package that includes medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, subject to eligibility.

Requirements

1–3 years of call center and/or customer service experience.
Basic computer knowledge and technical skills for using IP phones, customer records management systems, word processing, databases, and email/chat programs.
A private, confidential workspace free from distractions.
A hardwired connection, such as Ethernet.
Time management skills to respond promptly to emails, calls, and chat messages.
Active listening skills to effectively assist members who may be upset.
Ability to work Monday through Friday, 11:40 a.m. to 8:10 p.m. EST.
High school diploma or equivalent.

Nice To Haves

Mental health or human services background.
1–3 years of healthcare experience.
Bilingual or multilingual skills.
Experience working from home in a remote role.
Associate degree.

Responsibilities

Take inbound calls from members and determine effective ways to answer their questions.
Build an emotional connection with members by understanding and engaging them to support their health.
Maintain member records within the overall member management system.
Provide introductory information and connect members with appropriate additional benefits or external resources.
Review members’ claim history to track benefit maximums accurately, including deductible and coinsurance levels.
Explain members’ rights and responsibilities under plan sponsor contracts.
Send outbound emails to members as needed.
Troubleshoot member concerns and de-escalate interactions when needed.
Escalate queries and concerns when necessary.
Handle complaints and inquiries to support member satisfaction with products and services.
Share solutions and processes with the customer service team.
Embody CVS Core values in each interaction.