Experienced Customer Service Representative - Health Care Benefits Operations - Remote Work Opportunity

Introduction to CVS Health At CVS Health, we are driven by a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. As a Customer Service Representative - Health Care Benefits Operations, you will be the face of Aetna, impacting members' service experience by handling customer service inquiries and problems via telephone, internet, or written correspondence. Our Heart At Work Behaviors support this purpose, empowering everyone who works at CVS Health to feel valued and play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient, and affordable. Job Summary We are seeking a highly skilled and compassionate Customer Service Representative to join our Health Care Benefits Operations team. As a Customer Service Representative, you will engage, consult, and educate members based on their unique needs, preferences, and understanding of Aetna plans, tools, and resources. You will answer questions, resolve issues, and triage resulting rework to appropriate staff, ensuring that our members receive exceptional service and support. Your ability to create an emotional connection with our members, understand their needs, and champion their best health will be essential in this role. Key Responsibilities Handle customer service inquiries and problems via telephone, internet, or written correspondence, resolving issues in a timely and professional manner Engage, consult, and educate members based on their unique needs, preferences, and understanding of Aetna plans, tools, and resources Answer questions and resolve issues based on phone calls/letters from members, providers, and other departments Triage resulting rework to appropriate staff, ensuring that issues are resolved efficiently and effectively Document and track contacts with members, providers, and plan sponsors, maintaining accurate and up-to-date records Guide members through their plan of benefits, Aetna policy, and procedures, as well as knowledge of resources to comply with regulatory guidelines Create an emotional connection with our members by understanding and engaging them to the fullest, championing their best health Take accountability to fully understand the member's needs, building a trusting and caring relationship with the member Anticipate customer needs, providing related information to answer unasked questions, such as additional plan details, benefit plan details, member self-service tools, etc. Explain member's rights and responsibilities in accordance with contract, ensuring that members are informed and empowered to make informed decisions Essential Qualifications To be successful in this role, you will need: Customer service experience in a transaction-based environment, such as a call center or retail location, demonstrating the ability to be empathetic and compassionate Experience in a production environment, with a strong focus on efficiency and productivity High School or GED equivalent, with a strong foundation in communication and problem-solving skills Preferred Qualifications While not required, the following qualifications are preferred: Ability to multi-task to accomplish workload efficiently, with a strong focus on prioritization and time management Understanding of medical terminology, with the ability to communicate complex information in a clear and concise manner Oral and written communication skills, with the ability to articulate thoughts and ideas effectively Ability to maintain accuracy and production standards, with a strong focus on quality and attention to detail Problem-solving skills, with the ability to analyze complex issues and develop effective solutions Attention to detail and accuracy, with a strong focus on ensuring that all interactions are handled professionally and efficiently Analytical skills, with the ability to interpret data and develop insights to inform decision-making Skills and Competencies To be successful in this role, you will need to demonstrate the following skills and competencies: Demonstrating Service Discipline, with a strong focus on delivering exceptional customer service and support Creating a Differentiated Service Experience, with the ability to tailor interactions to meet the unique needs and preferences of our members Maximizing Work Practices, with a strong focus on efficiency, productivity, and quality Working Across Boundaries, with the ability to collaborate with cross-functional teams to achieve shared goals and objectives Handling Service Challenges, with the ability to analyze complex issues and develop effective solutions Career Growth Opportunities and Learning Benefits At CVS Health, we are committed to supporting the growth and development of our colleagues. As a Customer Service Representative, you will have access to a range of training and development opportunities, including: Comprehensive training programs, designed to equip you with the skills and knowledge needed to succeed in your role Opportunities for advancement, with a range of career paths and opportunities for professional growth Access to a range of learning resources, including online courses, workshops, and conferences A supportive and collaborative work environment, with a strong focus on teamwork and camaraderie Work Environment and Company Culture At CVS Health, we are proud of our diverse and inclusive workplace. We are committed to maintaining a culture that values and respects the contributions of all colleagues, regardless of their background, experience, or perspective. As a Customer Service Representative, you will be part of a dynamic and supportive team, with a strong focus on collaboration, innovation, and customer satisfaction. Compensation, Perks, and Benefits We offer a competitive salary range of $17.00 - $31.30 per hour, depending on experience and qualifications. In addition to your compensation, you will also be eligible for a range of benefits, including: Medical, dental, and vision benefits, designed to support your physical and mental well-being 401(k) retirement savings plan, with a range of investment options and employer matching contributions Employee Stock Purchase Plan, with the opportunity to purchase company stock at a discounted rate Term life insurance, with a range of coverage options and benefits Short-term and long-term disability benefits, designed to support you in the event of illness or injury Well-being programs, including fitness classes, health screenings, and employee assistance programs Education assistance, with a range of tuition reimbursement and scholarship opportunities CVS store discount, with exclusive discounts and savings on store purchases Discount programs with participating partners, with a range of savings and benefits on everyday purchases Paid Time Off (PTO) or vacation pay, with a range of paid holidays and time off benefits Conclusion If you are a motivated and compassionate individual, with a strong focus on delivering exceptional customer service and support, we encourage you to apply for this exciting opportunity. As a Customer Service Representative - Health Care Benefits Operations, you will be part of a dynamic and supportive team, with a range of opportunities for growth, development, and advancement. Don't miss out on this chance to join our team and make a real difference in the lives of our members. Apply now and take the first step towards a rewarding and challenging career with CVS Health. Apply for this job