Customer Service Representative - Behavioral Health (Monday-Friday 10:30AM-7:00PM EST)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

CVS Aetna has an opportunity available for a full time Customer Service Representative in the Behavioral Health team. This role provides advocate care to assist the member with a clear path to care, claims understanding and resolution and educates the member with online resources. The Customer Service Representative guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.

Position Overview
• Schedule: Monday-Friday 10:30 AM-7:00 PM EST
• *Schedules subject to change at any time with advanced notice due to business need.
• Holiday/PTO Requirements: As a 24-hour call center operation, we will treat holidays as normal working business days, unless you have been approved for time off. This means you would work your normal shift if the Company Observed Holiday falls on your normal workday. No PTO available the first 45 days of employment.
• Training Requirements: First six weeks of employment will be training on Monday-Friday 9:00AM-5:30PM EST.

What You Will Do
• Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health.
• Taking accountability to fully understand the member’s needs by building a trusting and caring relationship with the member.
• Anticipates customer needs.
• Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.
• Performs financial data maintenance as necessary.
• Explains member's rights and responsibilities in accordance with contract.

Required Qualifications
• 1+ years of experience in call center environment.
• Experience using Microsoft Office products’ specifically Excel, Outlook, and Word.

Workspace Requirements
• Technical Requirement for personal residential internet service.
• Recommended Technical requirements when obtaining your own residential internet service:
• Select an internet service that is either broadband or fiber (e.g., Verizon Fios, Comcast).
• Select a minimum of 25mbps/3mbps. Remember, the higher the speed, the faster your internet. A hardwired connection is required (ethernet connection); a wireless connection will introduce the risk of performance degradation.
• Consider the internet usage of others in the household during your scheduled working hours. You may need to obtain a higher speed internet connection so your ability to perform your work is not affected. Streaming video content and gaming will significantly reduce the amount of bandwidth available for your corporate equipment.

Preferred Qualifications
• Previous Behavioral Health, Medical, or Insurance background.
• Experience working from home in a remote role.

Education
• High School Diploma or GED.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$17.00 - $28.46

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great Benefits For Great People

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/17/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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