Job Summary

Aetna, a leading health insurance provider, is seeking a dedicated and compassionate Customer Support Representative to join our growing remote team. As part of our commitment to providing exceptional customer care, you will be the first point of contact for our members, helping them navigate their health insurance benefits and resolving any issues they may encounter. This remote position offers the flexibility of working from home while contributing to a positive impact on our members well-being and overall customer experience.

You will work in a fast-paced environment, where empathy, problem-solving, and effective communication are key to ensuring customer satisfaction. As a representative of Aetna, you will uphold our values of trust, integrity, and service excellence in every interaction.

Key Responsibilities

• Customer Assistance: Provide excellent customer support by answering inquiries related to health insurance coverage, claims, billing, benefits, and eligibility.
• Problem Resolution: Investigate and resolve customer concerns and complaints in a timely and professional manner, ensuring that members issues are addressed to their satisfaction.
• Claims and Benefits Support: Assist members with claims inquiries, explain benefits, and guide them through the process of understanding their coverage options.
• Documentation and Reporting: Accurately document customer interactions, feedback, and case resolutions in the system, ensuring all information is up-to-date and correct.
• Collaboration: Work closely with internal teams such as claims, billing, and provider relations to resolve complex customer issues.
• Follow-Up: Ensure that follow-up actions are completed as required, keeping customers informed on the status of their inquiries.
• Education and Guidance: Educate members on how to use Aetnas online resources, including member portals and apps, to access services and track their health benefits.

Required Skills and Qualifications

• Communication Skills: Excellent verbal and written communication skills, with the ability to convey complex information clearly and effectively to a diverse customer base.
• Problem-Solving: Strong analytical and problem-solving skills, with the ability to troubleshoot and provide solutions for customer inquiries.
• Attention to Detail: High level of attention to detail and accuracy in managing sensitive customer data and resolving issues.
• Time Management: Ability to manage time effectively, prioritize tasks, and handle multiple inquiries simultaneously in a high-volume, fast-paced environment.
• Tech-Savvy: Comfort with navigating multiple systems and tools, including CRM systems and Microsoft Office Suite.
• Customer-Centric Attitude: A genuine desire to help and support others, with a commitment to delivering a positive customer experience.
• Remote Work Readiness: Ability to work independently in a remote setting, with strong self-motivation and discipline.

Experience

• Education: High School Diploma or equivalent required; Associates degree or higher preferred.
• Experience:
  • Previous experience in customer service, particularly in the healthcare or insurance industry, is highly preferred.
  • Experience handling customer inquiries via phone, email, or live chat is a plus.
  • Knowledge of healthcare terminology and claims processing is beneficial but not mandatory.

Working Hours

• Shift Flexibility: This is a full-time remote position with flexible working hours. You may be required to work in different shifts, including evenings and weekends, depending on team needs and customer demand.
• Schedule: 40 hours per week, with a range of shifts available. Standard hours of operation are Monday through Friday, 9:00 AM to 6:00 PM EST, but flexibility is required to accommodate varying shifts as needed.

Knowledge, Skills, and Abilities

• Health Insurance Knowledge: Basic understanding of health insurance products, terminology, and processes is highly desirable.
• Customer Service: Proven experience in a customer-facing role, with the ability to manage customer expectations and resolve issues promptly.
• Multitasking Ability: Ability to handle multiple tasks efficiently and manage time effectively in a remote work environment.
• Cultural Competence: Ability to work with a diverse customer base, including individuals with varying levels of understanding of healthcare processes.
• Technical Proficiency: Strong computer skills, including proficiency with Microsoft Office tools and CRM software.

Benefits

• Health Insurance: Comprehensive medical, dental, and vision plans for you and your family.
• Retirement Savings: 401(k) plan with company match.
• Paid Time Off: Generous paid time off (PTO) and holiday pay.
• Work-Life Balance: Flexible working hours and the opportunity to work from home.
• Employee Assistance Programs: Mental health and wellness resources to support work-life balance.
• Career Development: Opportunities for career growth and advancement within Aetna and CVS Health.
• Employee Discounts: Discounts on health products and services, as well as other CVS Health perks.

Why Join Aetna?

At Aetna, we believe that what we do has a direct impact on the lives of millions of people. As part of the CVS Health family, we are committed to transforming the healthcare experience, making it simpler, more accessible, and more affordable.

Joining our team means being part of a supportive, diverse, and inclusive workplace where your contributions are valued. We invest in our employees growth and offer a range of development opportunities to help you build a rewarding career. Our remote roles provide you with the flexibility to work from the comfort of your home while making a meaningful difference in the lives of our members.

How to Apply

If you are passionate about helping others and want to be part of a dynamic and growing company, we encourage you to apply for the Aetna Customer Support Representative position. Please submit your resume and a cover letter detailing your relevant experience and interest in this role. To apply, visit our careers page at Aetna Careers or send your application directly to us. We look forward to learning more about how you can contribute to our mission of improving healthcare for all.