MUST RESIDE IN THE PHOENIX, AZ OR HOUSTON, TX METRO AREA

This position is based in Phoenix, AZ or Houston, TX and the ability to telework full time is required.

Working on the weekends (both Saturday and Sunday) and on holidays is required.

The 2nd Shift CSR hours are from 2:55 PM-11:25 PM AZ or 3:55 PM-12:25 AM CST on the weekdays. On the weekends, the hours vary. During Daylight Saving Time in the spring, the start time shifts to one hour earlier.

The 2nd Shift CSR works in the Afterhours Centralized Call Center and supports multiple Aetna Medicaid state health plans across the country.

Customer Service is the important first-line of contact with customers, setting the tone for how members, doctors and plan sponsor groups view our company. It provides members with the right information at the right time to help them make better decisions about their health and health care.

Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. Customer inquiries are of basic and at times complex nature. 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.

• Answers questions and resolves issues based on phone calls from members, providers, and plan sponsors.
• Documents and tracks contacts with members, providers and plan sponsors.
• The CSR guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.
• Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health.
• Taking accountability to fully understand 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.
• Explains member's rights and responsibilities in accordance with contract.
• Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues.

-Responds to requests received from Aetna's Law -

• Document Center regarding litigation; lawsuits

Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.16

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

• Must reside within 50 miles of the Phoenix or Houston location
• Customer Service experiences in a transaction based environment such as a call center or retail location, demonstrating ability to be empathetic and compassionate.
• All employees are required to commute to the office when experiencing internet outages or any technical problem that prevents them from working remotely
• Aetna/CVS Health furnishes the work-at-home equipment and employees are responsible for purchasing reliable internet connection at home with minimum download speed of 25 Mbps and an upload speed of 3Mpbs or more
• It is a requirement that an ethernet cord is used while working from home. Wifi does not always provide a reliable connection.

Preferred Qualifications

• Experience with working remotely
• Experience in the healthcare industry, preferably in a call center setting
• Knowledge of Medicaid and Medicare
• Proven strong performance attendance records

Education
High School Diploma or Equivalent

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.