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Remote Customer Service Representative - Aetna Medicaid Member Services at CVS Health

Remote, USA Full-time Posted 2025-11-03

Bring Your Heart to CVS Health: Transforming Healthcare through Compassionate Customer Service

At CVS Health, we're on a mission to revolutionize the way healthcare is delivered. Our purpose is simple yet profound: to bring our heart to every moment of your health. As a leading healthcare company, we're committed to making healthcare more personal, convenient, and affordable. We're seeking a dedicated and compassionate Remote Customer Service Representative to join our team, providing top-notch service to Aetna Medicaid members and providers.

About the Role: Aetna Medicaid Member Services Representative

As a Remote Customer Service Representative, you will be the primary point of contact for Aetna Medicaid members and providers, addressing their inquiries and concerns via phone. Your exceptional customer service skills, empathy, and knowledge of Medicaid and Medicare will enable you to deliver personalized support, resolve issues efficiently, and foster a positive experience for our callers.

Key Responsibilities:

  • Respond to inbound calls from members and providers, addressing inquiries regarding benefits, eligibility, services, prior authorization requirements, extra benefits, and programs.
  • Provide accurate and timely information, resolving issues and concerns in a professional and courteous manner.
  • Utilize our systems and tools to document interactions, update member information, and perform other tasks as required.
  • Maintain a high level of productivity, meeting performance standards, attendance requirements, and call quality goals.
  • Participate in ongoing training and development to stay up-to-date on Medicaid and Medicare policies, procedures, and benefits.
  • Work from home with a secure, high-speed internet connection via ethernet cable (Wi-Fi not permitted).
  • Company-provided equipment and training will be provided to support your success in this role.

Essential Qualifications:

  • Reside within 50 miles of Charleston, WV, with the ability to commute to the office when necessary (e.g., prolonged technical issues).
  • Excellent communication and interpersonal skills, with the ability to effectively interact with members and providers orally and in written form.
  • Proven ability to work independently in a remote setting, demonstrating self-motivation, discipline, and productivity.
  • High school diploma or equivalent required.

Preferred Qualifications:

  • Previous experience working in a remote call center environment, preferably in the healthcare or insurance industry.
  • Familiarity with Medicaid and Medicare policies, procedures, and benefits.
  • Strong knowledge of customer service principles and practices.

What We Offer: Comprehensive Benefits and Career Growth Opportunities

At CVS Health, we believe in rewarding our colleagues for their hard work and dedication. Our comprehensive benefits package includes:

  • Competitive compensation, with a pay range of $17.00 - $25.15 per hour.
  • Medical, dental, and vision benefits to support your overall well-being.
  • 401(k) retirement savings plan and Employee Stock Purchase Plan.
  • Term life insurance, short-term and long-term disability benefits.
  • Well-being programs, education assistance, and free development courses to support your personal and professional growth.
  • CVS store discount and discount programs with participating partners.
  • Paid Time Off (PTO) and paid holidays throughout the calendar year.

Our Culture: Heart At Work Behaviors

At CVS Health, we're committed to creating a culture that puts our heart into everything we do. Our Heart At Work Behaviors guide our interactions with colleagues, customers, and the communities we serve. We value diversity, equity, and inclusion, striving to create an environment where everyone feels empowered to contribute their best work.

COVID-19 Vaccination Policy

CVS Health requires certain colleagues to be fully vaccinated against COVID-19, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons. As a Remote Customer Service Representative, you will be required to provide proof of vaccination status or apply for a reasonable accommodation within the first 10 days of employment.

Equal Opportunity Employer

CVS Health is an equal opportunity employer, committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. We strive to provide equal access to the benefits and privileges of employment, including reasonable accommodations to perform essential job functions.

Ready to Join Our Team?

If you're passionate about delivering exceptional customer service, working in a dynamic and supportive environment, and making a meaningful difference in the lives of others, we encourage you to apply for this Remote Customer Service Representative role. Please submit your application, and our team will review it carefully.

Thank you for considering CVS Health as your next career step. We look forward to hearing from you!

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