Senior Customer Service Representative-Fully Remote
CVS Pharmacy - Franklin, TN
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Job DescriptionCustomer 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. Calls are typically non-routine and may require deviation from standard screens, scripts and procedures to engage, consult and educate 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. Act as subject matter expert by providing training, coaching, or responding to complex issues. Will be responsible to analyze and resolve issues associated with agent commissions. Answers questions and resolves issues as a "single-point-of-contact" based on phone calls, letters, and internet from brokers, marketing plan sponsors, PSS/ISO, members and providers. Activities may include providing Commission status information, benefit coverage interpretations, and explaining Commission transactions. Creates an emotional connection with our agents by understanding and engaging with agents. Taking accountability to fully understand the agent's needs by building a trusting and caring relationship with the agent. Anticipates agents needs. Provides the agent with related information to answer the unasked questions, e.g. additional details, benefit plan details, agent self-service tools, etc. Uses customer service threshold framework to make financial decisions to resolve agent issues.Processes commission transactions and addresses agent complaints. Escalates issues as appropriate through the target system for grievances and appeals. Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded. Through in-depth analysis, identifies complaint trends and any emerging agent service issues and works to develop solutions to address potential problems. Educates agent on various elements of information and available services created to enhance the overall customer service experience with the company (i.e., assistance with agent self-service tools).Partners with other departments to deliver client specific presentations. Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvements intended to enhance the overall delivery of service. Serves as SME providing technical assistance when needed on call related issues, products, and/or system applications delivery matters. Coaches, trains and assists in the development of call center staff. May participate and/or lead special projects/initiatives addressing service issues. May provide technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools. Delivers internal quality reviews. Provides appropriate support in third party audits when required. Documents and tracks all contacts, events, and outcomes with clients using appropriate systems and processes.Required QualificationsMust Have MS Excel (Pivot Tables, V look Ups, Basic Formulas)Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.Experience in a production or commission environment preferred.Demonstrated ability to handle multiple assignments competently, accurately and efficiently.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsSQL experience.Associate's degree or equivalent work experience.EducationAssociated degree or equivalent work experience.Business OverviewAt 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.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.
Created: 2024-09-07