Customer Service Representative, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 31.30 USD / Hour

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Job Description:

Customer Service Representative is the face of Aetna and impacts members' service experience by handling customer service inquiries and problems via telephone, internet or written correspondence. The role involves engaging, consulting and educating members based on their unique needs, preferences and understanding of Aetna plans, tools and resources to help guide members along a clear path to care.

Job Responsibility:

Handle customer service inquiries and problems via telephone, internet or written correspondence
Engage, consult and educate members based on their unique needs
Answer questions and resolve issues from members, providers, and plan sponsors
Document and track contacts with members, providers and plan sponsors
Guide members through their plan of benefits and Aetna policies
Process claim referrals, new claim handoffs, nurse reviews, complaints, grievance and appeals
Educate providers on self-service options
Assist providers with credentialing and re-credentialing issues
Respond to litigation requests
Handle file review requests
Prepare complaint trend reports
Compile claim data for customer audits
Determine medical necessity and verify member plan eligibility
Handle appeals and pre-authorizations
Review member claim history
Perform financial data maintenance

Requirements:

1 year of Customer service experience
Ability to multi-task to accomplish workload efficiently
Oral and written communication skills
Ability to maintain accuracy and production standards
Technical skills
Problem solving skills
Attention to detail and accuracy

Nice to have:

1 year of healthcare experience
1 year of call center experience
Reside in IL

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 25, 2025

Expiration:
October 13, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Customer Service Representative