Job description

To increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a full-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.

Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.90

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
Reviews and adjudicates claims for individual family plans.

Handles customer service inquiries and problems via telephone, internet, web-chat or written correspondence.
Engages, consults and educates members based upon the unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care.
Utilized resources to assist customer in understanding needs, preferences and understanding of Aetna CVS Health plans, tools and resources to help guide the members along a clear path to care.
Answers questions and resolves issues as a "single-point-of-contact" based on phone calls. Educates and assists customers on various elements of benefit plan information and available services to enhance the overall customer service experience.
Creates an emotional connection with our members by understanding and engaging them to the fullest.
Anticipates customer needs; providing them with related information to answer the unasked questions.
Takes ownership and immediate action to resolve the member issues.
Collaborates with other departments to solve member issues.
Strong multi tasking skills with ability to prioritize.

Preferred Qualifications
Effective organizational skills and ability to manage multiple tasks.
Effective communications skills, both verbal and written.
Associate's degree or equivalent work experience.

Education
High School diploma, G.E.D.

Business Overview
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. 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.

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