Customer Service Representative – Behavioral Health

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.

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.

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

Must be able to work between the hours of 8am-8pm EST

Shift will be assigned after offer and subject to change at least once a year.

• 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.

• 1-3 years of call center and/or customer service experience.
• 1-3 years of healthcare and/ or medical insurance 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.

• Background in mental health or human services.
• Bilingual or multilingual skills.
• Experience working from home in a remote role.
• Associates degree

• A high school diploma or equivalent.

40

Full time

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…