Customer Service Representative - Behavioral Health

CVS Health Corporation; United States; Remote; USD 26,000 - 43,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a full-time Customer Service Representative aligned with the Behavioral Health team to advocate for members, help them navigate benefits, and understand claims. The role emphasizes guiding members through their plan details and available resources with compassionate service.

After training (8 weeks, EST hours), you will work within a schedule that may include evenings. The position offers a comprehensive benefits package including medical, dental, and vision coverage, paid

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 Ethernet connection
• Time management to respond promptly to emails, calls, and chats.
• Active listening to effectively handle upset members.

Responsibilities

• Takes inbound calls from members and determines the quickest, most effective ways to answer questions.
• Creates an emotional connection with members by understanding and engaging them to champion their health.
• Records within the member management system.
• Provides introductory information and connects members with benefits/external resources.
• Reviews members' claim history to ensure accurate tracking of benefit maximums, including deductible and coinsurance levels.
• Explains members' rights and responsibilities per plan contracts.
• Sends outbound emails to members as needed.
• Supports members with troubleshooting and deescalation.
• Escalates queries and concerns when necessary.
• Ensures member satisfaction by handling complaints and inquiries.
• Works with the customer service team to share solutions and processes.

Skills

Call center experience

Customer service experience

Healthcare/medical insurance

Basic computer skills

Time management

Active listening

Education

High school diploma or equivalent

Associates degree

Tools

IP phones

CRM software

Word processing

Database

Email/Chat tools

Job description

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 ourselvesaccountable 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.

Training Schedule:

• Monday–Friday, 10:00 AM–6:30 PM EST
• Duration: 8 weeks

Available Work Schedules (Post‑Training):

• Must be able to work between the hours of 8am-8pm EST
• Shift will be assigned after offer and subject to change at least once a year.

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.
• er 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.
• Associates degree

Education:

• A high school diploma or equivalent.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $31.30

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

We anticipate the application window for this opening will close on: 10/03/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.