Customer Service Representative - Behavioral Health

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Summary:  

CVS Aetna has an opportunity available for a full-time Customer Service Representative aligned with the Behavioral Health team. This role provides advocate care to assist the member with a clear path to care, claims understanding/resolution, and member education around online resources. The Customer Service Representative guides the members through their members’ benefit plans and Aetna policy/procedures. They will also be expected to have knowledge of regulatory guidelines governing these resources. 

The Customer Service Representative position is ideal for someone with strong interpersonal skills, a passion for mental wellness advocacy, and is comfortable working with digital platforms in a fast-paced and emotionally sensitive setting. 

Training Schedule:

• Monday–Friday, 10:00 AM–6:30 PM EST

• Duration: 8 weeks

Available Work Schedules (Post‑Training):

• Midday Shifts:

  • Monday–Friday, 10:30 AM–6:00 PM EST

  • Monday–Friday, 11:00 AM–7:00 PM EST

• Evening Shift:

  • Monday–Friday, 11:45 AM–8:15 PM EST

Key Responsibilities:  

The Customer Service Representative's responsibilities include (but are not limited to) the following:

• Takes inbound calls from members and determines the quickest, most effective ways to answer member questions. 

• Creates an emotional connection with members by understanding and engaging them to champion their best health. 

• er records within the overall member management system  

• Provides introductory information and connects members with additional and appropriate benefits/external resources.  

• Performs a review of members’ claim history to ensure accurate tracking of benefit maximums, including deductible and coinsurance levels. 

• Explains members’ rights and responsibilities in accordance with our plan sponsors’ contracts. 

• Sends outbound e-mails to members where and as needed.  

• Supports members with troubleshooting and deescalating where needed. 

• Escalates queries and concerns when it is deemed necessary. 

• Ensures that members are satisfied with products/services by handling complaints and inquiries.  

• Works with the customer service team to share solutions and processes. 

• Embodies the CVS Core values in each interaction.  

Required Qualifications:  

• 1-3 years of call center and/or customer service experience. 

• 1-3 years of healthcare and/ or medical insurance experience. 

• Basic computer knowledge and technical skills to use IP phones, customer records management, word processing, database, and e-mail/chat programs.  

• A private and confidential workspace free from distractions. 

• A hardwired connection is required (i.e., an Ethernet connection). 

• Time management skills to promptly respond to e-mails, call, and chat messages. 

• Active listening skills to effectively handle members who may be upset. 

 Preferred Qualifications:  

• Background in mental health or human services.  

• Bilingual or multilingual skills.

• Experience working from home in a remote role.

Educational Requirements: 

• A high school diploma or equivalent is required.

• Associates degree preferred.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $25.65

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. 
 

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