Customer Service Representative - Behavioral Health (monday - friday 10:45am - 7:15pm EST) - Remote Eligible

Customer Service Representative

CVS Aetna has an opportunity available for a full time Customer Service Representative in the Behavioral Health team. This role provides advocate care to assist the member with a clear path to care, claims understanding and resolution and educates the member with online resources. The Customer Service Representative guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.

Schedule: Monday-Friday 10:45am -7:15pm EST. Schedules subject to change at any time with advanced notice due to business need.

Holiday/PTO Requirements: As a 24-hour call center operation, we will treat holidays as normal working business days, unless you have been approved for time off. This means you would work your normal shift if the Company Observed Holiday falls on your normal workday. No PTO available the first 45 days of employment.

Training Requirements: First six weeks of employment will be training on Monday-Friday 9:00AM-5:30PM EST.

What you will do:

• 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.

Workspace Requirements:

• 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. Remember, the higher the speed, the faster your internet. 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. Streaming video content and gaming will significantly reduce the amount of bandwidth available for your corporate equipment.

Required Qualifications:

• 1+ years of experience in a call center environment.
• Experience using Microsoft Office products' specifically Excel, Outlook, and Word.

Preferred Qualifications:

• Previous Behavioral Health, Medical, or Insurance background.
• Experience working from home in a remote role.

Education:

• High School Diploma or GED.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $17.00 - $34.15

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:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.