AK, WV, FL, MI, AZ, PA, NY, MN, NC NJ. EST, and CST
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 heart. Read reviews, benefits & salaries here
$1,000 Sign-on Bonus
Job Description
This position is permanent work from home for any candidate in the EST/CST time zone.
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 groups. 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 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-sharing.
Preferred Qualifications
• Customer Service experiences in a transaction-based environment such as a call center or retail location preferred, demonstrating the ability to be empathetic and compassionate.
• Effective organizational skills and ability to manage multiple tasks.
• Effective communication skills, both verbal and written Associate’s degree or equivalent work experience.
-$1,000 Sign-on BonusNJ
ob Description
This position is permanent work from home for any candidate in the EST time zone.
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 groups. 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 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-sharing.
Preferred Qualifications
• Customer Service experiences in a transaction-based environment such as a call center or retail location preferred, demonstrating the ability to be empathetic and compassionate.
• Effective organizational skills and ability to manage multiple tasks.
• Effective communication skills, both verbal and written Associate’s degree or equivalent work experience.
– $1,000 Sign-on Bonus
his position also includes a $1000 sign-on bonus as well as a post-training additional $2000 90 days post training! (Bonuses are only applicable to specific positions, locations, and business groups. Applicable roles have the bonus language in the job posting.)
Customer Service Representative is the face of Aetna and impacts members’ service experience by the 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.
Preferred Qualifications Customer Service experiences in a transaction-based environment such as an insurance call center, physician or hospital customer-facing position, demonstrate the ability to be empathetic and compassionate. Understanding of medical terminology and insurance concepts is important. Experience in a production environment. Ability to multi-task to accomplish workload efficiently. Oral and written communication skills. Ability to maintain accuracy and production standards. Negotiation skills. Technical skills. Problem-solving skills. Attention to detail and accuracy. Analytical skills.
Education High School or GED equivalent.
$1000 Sign-On Bonus Tallahassee, FL
This position is permanent work from home for any candidate in the CST time zone.
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-sharing.
Required Qualifications 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.
Plymouth, MN
Job Description Meritain Health’s Call Center has an opening for Customer Service Representatives. This is a work-from-home position at $17.50/ hour. This position handles customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature.
Required Qualifications Handle incoming calls from members and providers regarding claims status, benefits and eligibility, PPO participation, etc • Maintain department established performance metrics at a meets or exceeds expectations level • Work together as a team and apply the CVS Health Core Values in day-to-day operations • Creating a Differentiated Service Experience • Demonstrating Service Discipline • Handling Service Challenges • Providing Solutions to Constituent Needs • Working Across Boundaries
Preferred Qualifications • Call center and medical terminology/insurance experience • Experience in a production environment
Education High School diploma, G.E.D. or equivalent experience.
Job Description Meritain Health’s Call Center has multiple openings for Customer Service Representatives to support our Amherst, NY office. We are seeking candidates that reside in the state of NY. -This position handles customer service inquiries and problems via telephone, internet or written correspondence. -Customer inquiries are of basic and routine nature. -Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. -Triages resulting in rework to appropriate staff. -Documents and tracks contacts with members, providers and plan sponsors. -The CSR guides the member through their member's 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 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 the contract. -Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system. -Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues. -Response to requests received from Aetna’s Law Document Center regarding litigation; lawsuits Handles extensive file review requests. -Assists in the preparation of complaint trend reports. -Assists in compiling claim data for customer audits. -Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. -Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. -Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. -Performs financial data maintenance as necessary. -Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.
Required Qualifications -Customer Service experiences in a transaction-based environment such as a call center or retail location preferred, demonstrating the ability to be empathetic and compassionate. -Experience in a production environment.
Indianapolis, IN
Job Description Meritain Health’s Call Center has an opening for Customer Service Representatives in our Lansing, MI office. This position handles customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature.
Required Qualifications Creating a Differentiated Service Experience Demonstrating Service Discipline Handling Service Challenges
Preferred Qualifications Providing Solutions to Constituent Needs Working Across Boundaries
Education High School diploma, G.E.D. or equivalent experience.
Pittsburgh, PA
Job Description The role of the Customer Service Representative is to be a customer-focused, courteous, empathetic, service professional, who effectively uses knowledge of plans, products, procedures, and systems to provide information and resolve issues, resulting in enhanced customer satisfaction and retention. The Customer Service Representative position is Aetna’s window to our members, providers, physicians, and hospitals. As a Customer Service Representative, the image you project over the telephone and how you handle the caller’s situation is the public’s perception of Aetna. We provide a human connection when it is needed most.
Required Qualifications -Experience in a production environment. -Customer Service experiences in a transaction-based environment such as a call center or retail location preferred, demonstrating the ability to be empathetic and compassionate. -Strong communication and problem-solving skills -Empathy towards customers’ needs and concerns -Strong computer navigation and typing skills -Ability to manage multiple tasks in a transaction / high volume-based environment.
Phoenix, AZ
Job Description
Customer Service Representative is the face of Aetna and impacts members’ service experience by manner of how customer the 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/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors.
The CSR guides the member through their member's 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 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 members’ rights and responsibilities in accordance with the contract. Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system.
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 Handles extensive file review requests. Assists in the preparation of complaint trend report.
Assists in compiling claim data for customer audits. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management.
Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary. Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.
Tallahassee, FL
Job Description Meritain Health an Aetna/CVS affiliate has multiple openings for Customer Service Representatives in our permanent work from home role $17.50/hr wage. This position handles customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature. • Handle incoming calls from members and providers regarding claims status, benefits, and eligibility, PPO participation, etc • Maintain department established performance metrics at a meets or exceeds expectations level • Work together as a team and apply the Aetna Core Values in day-to-day operations • Creating a Differentiated Service Experience • Demonstrating Service Discipline • Handling Service Challenges • Providing Solutions to Constituent Needs • Working Across Boundaries
Required Qualifications • Call center and medical terminology/insurance experience • Experience in a production environment
Charleston, WV
Job Description Customer Service agent in Medicaid call center, answering incoming member and provider calls and responding to inquiries regarding benefits, eligibility, services, prior auth requirements, extra benefits, and programs, etc. Requires high-speed internet connectivity with secure service via ethernet cable, use of WiFi is not permitted. The company provides equipment and training.
Required Qualifications Medicaid call-center experience, QNXT, SUV, PeopleSafe, and other relevant systems, ability to communicate effectively with members and providers orally and in written form, ability to meet performance standards, attendance requirements and call quality goals
Preferred Qualifications Medicaid call-center experience, QNXT, SUV, PeopleSafe and other relevant systems, ability to communicate effectively with members and providers orally and in written form, ability to meet performance standards, attendance requirements and call quality goals
Education High school diploma or equivalent
Anchorage, AK
$17.50/hr. starting wage. Work From Home.
Meritain Health, an Aetna/CVS affiliate, has multiple openings for Customer Service Representatives.
This position handles customer service inquiries and problems via telephone, internet, or written correspondence. Customer inquiries are of basic and routine nature.
Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors.
Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors.
The CSR guides the member through their member's 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 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 members’ rights and responsibilities in accordance with contract.
Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system. 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 Handles extensive file review requests.
Assists in the preparation of complaint trend report. Assists in compiling claim data for customer audits.
Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. ]
Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary. Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.
Job Description
Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff.
Documents and tracks contacts with members, providers and plan sponsors. The CSR guides the member through their member's 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 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 members’ rights and responsibilities in accordance with the contract. Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system .
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 Handles extensive file review requests. Assists in the preparation of complaint trend report.
Assists in compiling claim data for customer audits. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management.
Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary.
Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.
Job Description Meritain Health’s Call Center has an opening for Customer Service Representatives in our Lansing, MI office. This position handles customer service inquiries and problems via , telephone, internet or written correspondence. Customer inquiries are of basic and routine nature.
Required Qualifications Creating a Differentiated Service Experience Demonstrating Service Discipline Handling Service Challenges
Preferred Qualifications Providing Solutions to Constituent Needs Working Across Boundaries
Education High School diploma, G.E.D. or equivalent experience.
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