Customer Service Representative - Work from Home- $1,000 Sign on Bonus
Company: Aetna Inc.
Posted on: January 15, 2022
This position is permanent work from home for any candidate in the
PST/ EST time zones.
This position also includes a $1000 sign on bonus as well as an
additional $2000 90 days post training! (Bonuses are only
applicable to specific positions, locations, and business
Applicable roles have the bonus language in the job posting.)Health
Concierge is the face of Aetna to provide targeted, personalized
service based on a holistic view of the member, benefits, health
information, and through engagement.
Handles customer service inquiries and problems via telephone,
internet, web-chat or written correspondence. 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. Utilizes resources to
assist customers in understanding components of the Aetna products
including claims, accumulators, usage and balances, and cost
* Answers questions and resolves issues as a
"single-point-of-contact" based on phone calls, plan sponsors,
PSS/ISO, members and providers. Provides customized interaction
based on customer preference and individualized needs, creating an
emotional connection with our members by understanding and engaging
the member to the fullest.
* Fully understands 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.
* Uses customer service threshold framework to make financial
decisions to resolve member issues.
* Educates and assists customers on various elements of benefit
plan information and available services created to enhance the
overall customer service experience with the company (i.e.,
assistance with member self-service tools, Consultation
Opportunities - Simple Steps, Cost of Care Tools, Natural
Alternatives Program, etc.).
* Utilizes all relevant information to effectively influence member
* Takes immediate action when confronted with a problem or made
aware of a situation.
* Takes ownership of each customer contact to resolve their issues
and connect them with additional services as appropriate.
* Identifies member needs beyond the initial inquiry by answering
the unasked questions.
* Resolves issues without or with limited management
* Provides education to members to support them in managing their
* Responds quickly to meet customer needs and resolve problems
while avoiding over-committing.
* Other activities may include: providing claim status information,
benefit coverage interpretations, and explaining plan
* Processes claim referrals, new claim hand-offs, and escalates
issues as appropriate through the system for grievances and
* Initiates out-reach/welcome calls to ensure constituents
expectations are met or exceeded. Identifies trends and any
emerging customer service issues and works to develop solutions to
address potential problems and/or plan features of interest as an
approach to improve understanding of benefit plans and increase
post-enrollment member satisfaction.
* Partners with other departments to deliver client specific
* Coordinates efforts both internally and across departments to
successfully resolve service issues and develop process improvement
intended to enhance the overall delivery of service.
* Works collaboratively with colleagues to deliver the best
* Seeks to understand the customer, including circumstances,
problems, expectations and needs.
* Asks probing questions to identify the underlying customer
* Appropriately transitions conversations to explore possibilities
for extending customer interactions.
* Guides members to the appropriate health resource. Offers
alternatives where appropriate .
* Acts with the best interest of customer in mind and central to
* Collaborates with colleagues and co-workers to deliver a world
class customer experience.
* Serves as SME providing technical assistance when needed on call
related issues, products, and/or system applications delivery
* May participate in preparation and presentation of client
* May track and trend data. Coaches, trains and assists in the
development of call center staff, as required.
* Participates in and/or leads special projects/initiatives
addressing service issues, as necessary.
* Provides technical or subject matter expertise concerning
policies, procedures, and function-related applications/systems
tools as needed.
* Delivers internal quality reviews.
* Provides appropriate support in third party audits when required.
Documents and tracks all contacts, events, and outcomes with
clients using appropriate systems and processes
CVS Health requires its Colleagues to be fully vaccinated against
COVID-19 (including any booster shots if required), where allowable
under the law, unless they are approved for a reasonable
accommodation based on disability, medical condition, or religious
belief that prevents them from being vaccinated.
If you are vaccinated, you are required to have received at least
one COVID-19 shot prior to your first day of employment and to
provide proof of your vaccination status within the first 10 days
of your employment. For the two COVID-19 shot regimen, you will be
required to provide proof of your second COVID-19 shot within the
first 45 days of your employment. In some states and roles, you may
be required to provide proof of full vaccination before you can
begin to actively work. Failure to provide timely proof of your
COVID-19 vaccination status will result in the termination of your
employment with CVS Health.
If you are unable to be fully vaccinated due to disability, medical
condition, or religious belief, you will be required to apply for a
reasonable accommodation within the first 10 days of your
employment in order to remain employed with CVS Health. As a part
of this process, you will be required to provide information or
documentation about the reason you cannot be vaccinated. In some
states and roles, you may be required to have an approved
reasonable accommodation before you can begin to actively work. If
your request for an accommodation is not approved, then your
employment may be terminated.
* Customer Service experiences in a transaction based environment
such as a call center or retail location preferred, demonstrating
ability to be empathetic and compassionate.
* Effective organizational skills and ability to manage multiple
* Effective communication skills, both verbal and written
Associate's degree or equivalent work experience
Additional Job Information
Innovative Thinking and "Change Agent" - Looks for, identifies and
acts on opportunities to improve how we design, develop, and
deliver products and services. Strong analytical skills and
innovative problem solving abilities. Strong negotiation and
collaboration skills. In-depth knowledge of benefits program and
system design (Health and Welfare, Wealth, other employee
benefits), related financials, legal/regulatory requirements.
Empathy towards customers' needs and concerns. Ability to maintain
accuracy and production standards. Technical skills. Attention to
detail and accuracy.
High School Diploma
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
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
Keywords: Aetna Inc., Fresno , Customer Service Representative - Work from Home- $1,000 Sign on Bonus, Hospitality & Tourism , Fresno, California
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