Customer Service Representative Dental (Business Healthcare)

• Dental Customer 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. • Customer inquiries are of basic and at times complex in 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 Dental CSR guides the member through their members 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 for 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 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.

Required Qualifications • 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 environment.

https://jobs.cvshealth.com/job/18764059/customer-service-representative-dental-hcb-ops/

This $17.50 per hour Dental Customer Service position is permanent work from home.

Employer: CVS
Location: Remote
Link: https://jobs.cvshealth.com/job/18764059/customer-service-representative-dental-hcb-ops/