Description

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.

Job Summary:

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.

Training Schedule:

• Monday-Friday, 10:00 AM-6:30 PM EST
• Duration: 8 weeks

Available Work Schedules (Post‑Training):

• Midday Shifts:
  
  • Monday-Friday, 10:30 AM-6:00 PM EST
  • Monday-Friday, 11:00 AM-7:00 PM EST
• Evening Shift:
  
  • Monday-Friday, 11:45 AM-8:15 PM EST

Key Responsibilities:

The Customer Service Representative's responsibilities include (but are not limited to) the following:

• 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.

Required 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.

Preferred Qualifications:

• 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.

Educational Requirements:

• A high school diploma or equivalent is required.
• Associates degree preferred.

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

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, and other resources, based on eligibility.

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

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.