Customer Service Representative - Behavioral Health, CVS Health

CVS Health

Location:
United States, Work at Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 34.15 USD / Hour

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Job offer has expired

Job 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 members with a clear path to care, claims understanding/resolution, and member education around online resources. The Customer Service Representative guides the members through their respective benefit plans and Aetna policy/procedures. They will also be expected to have knowledge of regulatory guidelines governing these resources.

Job Responsibility:

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 member 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 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

Requirements:

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 (i.e., an Ethernet connection)
High school diploma or GED

Nice to have:

Background in mental health or human services
1-3 years of healthcare and/or medical claims experience
Bilingual or multilingual skills
Experience working from home in a remote role
Time management skills to promptly respond to e-mails, call, and chat messages
Active listening skills to effectively handle members who may be upset
Associate's degree

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 24, 2025

Expiration:
October 30, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Customer Service Representative - Behavioral Health