[Hiring] Customer Service Representative @CVS Health

Role Description

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.

• 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
• Maintains accurate 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

Qualifications

• 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
• Must be able to work schedule of Monday-Friday 11:40am - 8:10pm

Preferred Qualifications

• A mental health or human services background is preferred
• 1-3 years of healthcare experience is preferred
• Bilingual or multilingual skills are a plus
• Experience working from home in a remote role is preferred
• An Associates degree is a plus

Educational Requirements

• A high school diploma or equivalent is required

Anticipated Weekly Hours

• 40

Time Type

• Full time

Pay Range

The typical pay range for this role is: $17.00 - $31.30. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

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
• Other resources, based on eligibility

Additional details about available benefits are provided during the application process and on Benefits Moments.