Customer Service Representative, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

17.00 - 28.46 USD / Hour

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Job Description:

Customer Service Representative role at CVS Health's Center of Excellence Customer Service group, serving as the face of Aetna to handle customer service inquiries and problems via telephone, internet or written correspondence, engaging and educating members about their health plans and benefits.

Job Responsibility:

Customer Service Representative is the face of Aetna and impacts members' service experience
Handles customer service inquiries and problems via telephone, internet or written correspondence
Engages, consults and educates members based upon the member's unique needs
Answers questions and resolves issues from members, providers, and plan sponsors
Documents and tracks contacts with members, providers and plan sponsors
Guides members through their plan of benefits and Aetna policy
Creates an emotional connection with members
Processes claim referrals, new claim handoffs, nurse reviews, complaints
Educates providers on self-service options
Responds to requests from Aetna's Law Document Center
Handles extensive file review requests
Assists in preparation of complaint trend reports
Determines medical necessity and verifies member plan eligibility

Requirements:

Customer Service experiences in a transaction based environment such as a call center or retail location preferred
Experience in a production environment
High School diploma, G.E.D. or equivalent experience

Nice to have:

Ability to multi-task to accomplish workload efficiently
Understanding of medical terminology
Strong oral and written communication skills
Ability to maintain accuracy and production standards
Problem solving skills
Attention to detail and accuracy
Analytical skills

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
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 10, 2025

Expiration:
September 12, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Customer Service Representative