Customer Service Representative, CVS Health

CVS Health

Location:
United States, Remote

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 31.30 USD / Hour

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Job Description:

Customer Service Representative position at CVS Health's Center of Excellence Customer Service group, working remotely to handle customer service inquiries and problems via telephone, internet or written correspondence for Aetna members. The role involves engaging, consulting and educating members about their health plans, tools and resources.

Job Responsibility:

Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled
Engages, consults and educates members based upon the member's unique needs, preferences and understanding of Aetna plans, tools and resources
Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors
Documents and tracks contacts with members, providers and plan sponsors
Guides members through their benefits plan and Aetna policy and procedures
Processes claim referrals, new claim handoffs, nurse reviews, complaints, grievance and appeals
Educates providers on self-service options
Assists providers with credentialing and re-credentialing issues
Determines medical necessity, applicable coverage provisions and verifies member plan eligibility

Requirements:

1+ years of Customer Service
Must have high speed internet with consistent speeds above 25mbps and adherence to telework agreement (wired in)
Must be willing to work Monday - Friday 8:35a-5:05p or 9:30a-6:00p EST
High School diploma, G.E.D. or equivalent experience

Nice to have:

1+ years of Healthcare experience
Experience in a production environment
Prior experience providing customer service to the senior population, knowledge of medical terminology including Medicare and Medicaid policies

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
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:
September 28, 2025

Expiration:
October 06, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Customer Service Representative