Experienced Customer Service Representative – Work from Home Opportunity with CVS Health, Delivering Exceptional Patient Experiences and Driving Business Growth through Compassionate Care and Innovative Solutions

Introduction to CVS Health and Our Mission At CVS Health, we are driven by a singular, clear purpose: to bring our hearts to every moment of our customers' health. This purpose guides our commitment to delivering improved, human-driven healthcare for a rapidly changing world. Embedded in our brand – with the heart at its center – our mission sends a personal message that how we deliver our services is as important as what we deliver. We are seeking a dedicated and compassionate Customer Service Representative to join our team, working from the comfort of their own home, to provide exceptional support to our patients and drive business growth through innovative solutions. Job Overview and Responsibilities In this critical role, you will be responsible for enhancing customer satisfaction, retention, and growth by efficiently delivering high-quality services to individuals and providers through a fully integrated organization staffed by knowledgeable, customer-centric professionals supported by exemplary technologies and processes. As the face of Aetna, you will influence individuals' service experience by how customer support requests and issues are handled via phone, web, or written communication. Respond to customer inquiries and resolve issues in a timely and professional manner, utilizing your knowledge of Aetna plans, tools, and resources to guide individuals along a path to care. Connect with, consult, and educate individuals based on their unique needs, preferences, and understanding of Aetna plans, tools, and resources. Report and track contacts with individuals, providers, and plan sponsors, ensuring seamless communication and follow-up. Utilize customer support edge system to make financial decisions to resolve customer issues, explaining plan limitations and contract details as needed. Process claim referrals, new case handoffs, nurse reviews, complaints, and requests through the objective system, ensuring accurate and efficient processing. Teach providers about self-service options and assist with credentialing and re-credentialing issues, promoting a collaborative and supportive environment. Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management, ensuring timely and effective support. Perform review of customer claim history to ensure accurate tracking of benefit maximums and coinsurance/deductible, maintaining precise records and data. Essential Qualifications and Skills To succeed in this role, you will need: Customer service experience in a transaction-based environment, such as a call center, with a proven track record of delivering exceptional support and resolving complex issues. Experience in a production environment, with the ability to work efficiently and effectively in a fast-paced setting. Strong technical knowledge of the capability being trained, with the ability to quickly learn and adapt to new systems and processes. Excellent communication and interpersonal skills, with the ability to build strong relationships with customers, providers, and internal stakeholders. Ability to work independently in a home-based setting, with minimal supervision, and maintain a high level of productivity and motivation. Preferred Qualifications and Skills While not required, the following qualifications and skills are preferred: Medicaid or healthcare experience, with a deep understanding of the healthcare industry and its complexities. Education beyond high school, with a degree in a related field such as healthcare administration, customer service, or communications. Experience working with diverse customer populations, with a strong understanding of cultural competency and sensitivity. Proficiency in multiple languages, with the ability to communicate effectively with customers who speak languages other than English. Career Growth Opportunities and Learning Benefits At CVS Health, we are committed to the growth and development of our employees, providing opportunities for career advancement and professional development. As a Customer Service Representative, you will have access to: Comprehensive training programs, designed to enhance your knowledge and skills in customer service, healthcare, and technology. Opportunities for career advancement, with a clear path for professional growth and development. A supportive and collaborative work environment, with a team of experienced professionals who are dedicated to delivering exceptional customer support. Access to cutting-edge technology and systems, with ongoing training and support to ensure your success. Work Environment and Company Culture At CVS Health, we are proud of our company culture, which is built on a foundation of integrity, respect, and compassion. As a Customer Service Representative, you will be working in a home-based setting, with the flexibility to create your own schedule and work environment. You will be part of a dynamic and supportive team, with a strong focus on collaboration, communication, and customer satisfaction. A comprehensive benefits package, including medical, dental, and vision coverage, as well as a 401(k) plan and paid time off. A competitive salary, with opportunities for bonuses and incentives based on performance. A supportive and inclusive work environment, with a strong focus on diversity, equity, and inclusion. Access to employee recognition and reward programs, with opportunities to celebrate your successes and contributions. Compensation, Perks, and Benefits We offer a competitive salary range of $28-$35 per hour, depending on experience, as well as a comprehensive benefits package, including: Medical, dental, and vision coverage, with a range of plan options to suit your needs. A 401(k) plan, with a company match, to help you save for your future. Paid time off, including vacation, sick leave, and holidays, to ensure you have time to rest and recharge. Employee recognition and reward programs, with opportunities to celebrate your successes and contributions. Access to cutting-edge technology and systems, with ongoing training and support to ensure your success. Conclusion and Call to Action If you are a motivated and compassionate individual, with a passion for delivering exceptional customer support, we encourage you to apply for this exciting opportunity. As a Customer Service Representative with CVS Health, you will be part of a dynamic and supportive team, with a strong focus on collaboration, communication, and customer satisfaction. Don't miss out on this chance to join our team and make a difference in the lives of our customers. Apply today! Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today and take the first step towards an exciting and rewarding career with CVS Health. Apply for this job