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Customer Service Representative - Behavioral Health

CVS Health · Centralia, WA

Full-timeCustomer Service/Call CenterPosted Jul 24, 2026
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Job description

Customer Service Representative We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job Summary: CVS Aetna has an opportunity available for a full-time Customer Service Representative aligned with the Behavioral Health team. This role provides advocate care to assist the member with a clear path to care, claims understanding/resolution, and member education around online resources. The Customer Service Representative guides the members through their members' benefit plans and Aetna policy/procedures. They will also be expected to have knowledge of regulatory guidelines governing these resources. The Customer Service Representative position is ideal for someone with strong interpersonal skills, a passion for mental wellness advocacy, and is comfortable working with digital platforms in a fast-paced and emotionally sensitive setting. Training Schedule: • Monday–Friday, 10:00 AM–6:30 PM EST • Duration: 8 weeks Available Work Schedules (Post‑Training): • Midday Shifts: • Monday–Friday, 10:30 AM–6:00 PM EST • Monday–Friday, 11:00 AM–7:00 PM EST • Evening Shift: • Monday–Friday, 11:45 AM–8:15 PM EST Key Responsibilities: • Takes inbound calls from members and determines the quickest, most effective ways to answer member questions. • Creates an emotional connection with members by understanding and engaging them to champion their best health. • Records within the overall member management system • Provides introductory information and connects members with additional and appropriate benefits/external resources. • Performs a review of members' claim history to ensure accurate tracking of benefit maximums, including deductible and coinsurance levels. • Explains members' rights and responsibilities in accordance with our plan sponsors' contracts. • Sends outbound e-mails to members where and as needed. • Supports members with troubleshooting and deescalating where needed. • Escalates queries and concerns when it is deemed necessary. • Ensures that members are satisfied with products/services by handling complaints and inquiries. • Works with the customer service team to share solutions and processes. • Embodies the CVS Core values in each interaction. Required Qualifications: • 1-3 years of call center and/or customer service experience. • 1-3 years of healthcare and/ or medical insurance experience. • Basic computer knowledge and technical skills to use IP phones, customer records management, word processing, database, and e-mail/chat programs. • A private and confidential workspace free from distractions. • A hardwired connection is required (i.e., an Ethernet connection). • Time management skills to promptly respond to e-mails, call, and chat messages. • Active listening skills to effectively handle members who may be upset. Preferred Qualifications: • Background in mental health or human services. • Bilingual or multilingual skills. • Experience working from home in a remote role. Educational Requirements: • A high school diploma or equivalent is required. • Associates degree preferred. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $25.65 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. We anticipate the application window for this opening will close on: 07/24/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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Customer Service Representative We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Customer Service Representative is a phone-based role. This person serves as a primary point of contact for long-term care residents, responsible parties, and facility partners. This role is responsible for providing exceptional customer support while ensuring billing accuracy, account reconciliation, payment processing, and compliance with company policies and regulatory requirements. The Customer Service Representative will work closely with customers to resolve account inquiries, verify billing and insurance information, and support organizational initiatives designed to enhance the customer experience and operational effectiveness. Primary Responsibilities • Serve as the primary customer support resource for long-term care residents, responsible parties, and facility staff regarding account inquiries and billing concerns. • Collect, review, and verify account-specific information, including billing details, insurance coverage, payer information, and applicable coding. • Update, maintain, and document customer account activities within designated work campaigns and servicing platforms. • Review account status to verify accuracy, identify discrepancies, and take appropriate action to progress accounts toward resolution. • Conduct outbound calls to customers, responsible parties, insurance providers, and facilities to reconcile account issues and resolve outstanding balances. • Process customer payments accurately and perform follow-up activities to ensure proper posting and account resolution. • Research and resolve billing questions, payment concerns, and account discrepancies in a professional and timely manner. • Maintain detailed and accurate documentation of all customer interactions and account activity. • Ensure compliance with all federal and state regulations, company policies, privacy standards, and departmental procedures. • Participate in corporate campaigns, special projects, and strategic initiatives that support organizational goals and leadership-directed objectives. • Collaborate with internal departments to resolve customer concerns and improve overall service delivery. • Meet established performance, quality, and productivity standards while delivering a positive customer experience. • Perform other duties as needed. Required Qualifications • 1+ year of experience in a high-volume call center environment. • 1+ year of experience with health insurance billing, including Medicaid, Medicare, and/or Medicare Part D. • 1+ year of experience in a remote, work-from-home environment. • Demonstrated proficiency in working multiple systems simultaneously, as well as with Microsoft Office (Outlook, Word, Excel). Preferred Qualifications • Previous experience in a long-term care and/or pharmaceutical environment. • Strong written and verbal communication skills. • Demonstrated professional demeanor in all communications. • Excellent attention to detail. • Strong administrative and data entry skills. • Ability to build relationships with customers and members. • Excellent customer service skills. • Strong problem-solving, investigative, and conflict-resolution skills. • Associate's degree. Education • High school diploma or GED. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $34.15 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

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