Description

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, aligned with the Behavioral Health team. This role provides advocate care to assist members with a clear path to care, claims understanding/resolution, and member education around online resources. The Customer Service Representative guides the members through their respective 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.

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.
• Maintains member 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 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.
• 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 (i.e., an Ethernet connection).

Preferred Qualifications:

• Background in mental health or human services.
• 1-3 of healthcare and/or medical claims experience.
• Bilingual or multilingual skills.
• Experience working from home in a remote role.
• Time management skills to promptly respond to e-mails, call, and chat messages.
• Active listening skills to effectively handle members who may be upset
• Associate's degree.

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 - $34.15

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: 10/30/2025

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