Customer Srvc Rep - HCB Ops

Bring your heart to CVS Health. Every one of us at CVS Health shares 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. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary :

Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. Customer inquiries are basic and at times complex nature. Engages, consults and educates members based upon the member’s unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care. Answers questions and resolves issues based on phone calls/letters from members, providers, and other departments. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors.
The CSR 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.
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.
Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
Explains member's rights and responsibilities in accordance with contract.

Required Qualifications :

Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate. Experience in a production environment. High School or GED equivalent.

Preferred Qualifications :

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

Education :

High School diploma, G.E.D. or equivalent experience

Required Skills:

Demonstrating Service Discipline

Creating a Differentiated Service Experience

Maximizing Work Practices

Desired Skills:

Working Across Boundaries

Handling Service Challenges

Required Skills

General Business/Maximizing Work Practices/ADVANCED

Service/Creating a Differentiated Service Experience/ADVANCED

Service/Demonstrating Service Discipline/FOUNDATION

Desired Skills

Service/Handling Service Challenges/ADVANCED

Service/Working Across Boundaries/ADVANCED

Required Skills:

Service/Creating a Differentiated Service Experience/ADVANCED

Service/Providing Solutions to Constituent Needs/FOUNDATION

Service/Working Across Boundaries/ADVANCED

Desired Skills:

General Business/Maximizing Work Practices/ADVANCED

Leadership/Fostering a Global Perspective/FOUNDATION

Service/Handling Service Challenges/ADVANCED

Business Overview :

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Pay Range

The typical pay range for this role is