Experienced Aetna Customer Service Representati...
Join the CVS Health Family and Make a Difference in Healthcare At CVS Health, we share a common purpose: to bring our heart to every moment of your health. Our mission is to deliver enhanced, human-driven healthcare for a rapidly changing world. We're committed to making healthcare more personal, convenient, and affordable. As a leading healthcare company, we're dedicated to creating a culture that values empathy, compassion, and inclusivity. About the Role We're seeking an experienced and compassionate Aetna Customer Service Representative to join our team. As a Customer Service Agent, you'll be the face of Aetna, influencing individuals' service experience through phone, web, or written correspondence. You'll respond to complex customer inquiries, resolve issues, and provide guidance on Aetna plans, tools, and resources. Key Responsibilities * Respond to questions and resolve issues from individuals, providers, and plan sponsors via phone, letters, or online correspondence * Record and track contacts with individuals, providers, and plan sponsors * Guide members through their plan benefits, Aetna policies, and procedures, while being aware of resources to comply with regulatory rules * Build personal connections with members by understanding and engaging them to support their best health * Take ownership of understanding members' needs by building trusting and caring relationships * Anticipate customer needs and provide related information to address unasked questions * Utilize customer service limit systems to make financial decisions to resolve member issues * Explain members' limitations according to contract * Process claim references, new case handoffs, nurse reviews, complaints, and requests via target systems * Educate providers on self-service options and assist with credentialing and re-credentialing issues * Handle incoming requests for information and pre-approvals not handled by Clinical Case Management * Perform reviews of member claim history to ensure accurate tracking of benefit maximums and coinsurance/deductible Requirements and Qualifications * **Essential Qualifications:** + Customer service experience in a transactional environment, such as a call center or retail store + Ability to multitask and efficiently achieve responsibilities + Understanding of clinical terminology + Proficient oral and written communication skills + Proficient with Microsoft Word and Outlook + Ability to maintain accuracy and production standards + Strong problem-solving skills and attention to detail * **Preferred Qualifications:** + Experience in a production environment + Familiarity with Aetna plans and policies + Strong analytical skills What We Offer * Competitive $25/hour salary * Comprehensive benefits package, including: + Clinical, dental, and vision benefits + 401(k) retirement savings plan and Employee Stock Purchase Plan + Fully paid term life insurance plan + Short-term and long-term disability benefits + Various wellness programs and education assistance + Free development courses and CVS store discounts + Paid time off (PTO) and vacation pay + Paid holidays throughout the year Work Environment and Culture * Remote work opportunity with flexible scheduling * Collaborative and dynamic work environment * Opportunities for career growth and professional development * Culture that values empathy, compassion, and inclusivity How to Apply If you're passionate about delivering exceptional customer service and making a difference in healthcare, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. Don't miss this chance to join the CVS Health family and be part of a team that's dedicated to bringing our heart to every moment of your health. Apply today! Apply for this job