Hiring Organization: Aetna

Post Name: Customer Service Representative

Qualifications: Graduation

Work Hours: 8

Salary: $20-$30/Hour

Locations: Honolulu, USA

Job Description:

Answers questions and resolves issues as a 'single point of contact' based on phone calls, plan sponsors, PSS/ISOs, members and suppliers. Provides personalized interaction based on customer preferences and individual needs, creating an emotional connection with our members by best understanding and engaging them. Fully understands the member's needs by building a trusting and caring relationship with the member.

• Anticipate customer needs. Provides the customer with related information to answer unasked questions, e.g. more plan details, benefit plan details, member self-service tools, etc.
• Use the customer service threshold framework to make financial decisions to resolve member issues. Educates and assists clients on various elements of benefit plan information and available services designed to enhance the overall customer service experience with the company (e.g. etc.).
• Use all relevant information to effectively influence member engagement. Acts immediately when faced with a problem or becomes aware of a situation.
• He takes responsibility for each customer contact to solve his problems and connect them with additional services as appropriate. Identify member needs beyond the initial consultation by answering unasked questions.
• Resolves problems with or without management intervention. It provides education to members to support them in managing their health.
• Respond quickly to meet customer needs and resolve issues without over-engagement. Other tasks may include providing information about the status of your claim, interpretations of benefit coverage, and explaining your plan eligibility.

Process grievance referrals, new grievance transfers, and escalate issues as appropriate through the grievance and appeals system. Initiate outreach/welcome calls to ensure voter expectations are met or exceeded. Identify trends and any emerging customer service issues and work to develop solutions to address potential issues and/or plan features of interest as an approach to improve understanding of benefit plans and increase member satisfaction upon enrollment. Collaborate with other departments to deliver client-specific presentations.

• Coordinates efforts both internally and across departments to successfully resolve service issues and develop improvement processes aimed at improving overall service delivery. Work collaboratively with colleagues to deliver the best customer experience.
• Seek to understand the customer, including their circumstances, problems, expectations and needs. Asks probing questions to identify underlying customer needs.
• Appropriate conversation transitions to explore possibilities for expanding customer interactions. Guide members to the appropriate health resource. Offer alternatives when appropriate. Acts in the customer's best interest and is central to all interactions.
• Collaborate with peers and peers to deliver a top-notch customer experience. Performs the PMI function by providing technical assistance when needed on issues related to tenders, products and/or issues related to the delivery of system applications.
• May participate in the preparation and delivery of client-specific presentations. You can track and trend data. Coaches, coaches and assists in developing call center staff as needed. Participates in and/or leads special projects/initiatives addressing service issues as needed.
• Provides technical or subject matter expertise related to function related system/application policies, procedures and tools as needed. Offers internal quality reviews.
• Provides adequate support in third party audits when required. Document and track all customer contacts, events and outcomes using appropriate systems and processes
• Please note that this range represents the salary range for all positions in the job tier this position falls into. The actual salary offer will take into account a wide range of factors including location. Qualifications Required
• Customer service experiences in a transaction-based environment, such as a call center or retail store, that demonstrate an ability to be empathetic and compassionate are preferred.
• Effective organizational skills and ability to manage multiple tasks. Effective communication skills, both verbal and written.

preferred qualifications

View required qualifications

Education

High school diploma is required

Overview of business activities

Bring Your Heart to CVS Health Each of us at CVS Health shares a single, clear purpose: to bring our hearts into every moment of your health. This purpose drives our efforts to deliver better human-centered health care for a rapidly changing world. Anchored in our brand, with our hearts at its core, our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ supports this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient and affordable. We strive every day to promote and sustain a culture of diversity, inclusion and belonging. CVS Health is an Affirmative Action Employer and is an Equal Opportunity Employer, as are physician-owned businesses for which CVS Health provides management services. We do not discriminate against the recruitment, hiring, promotion or any other action of personnel based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, status of protected veteran or any other characteristic protected by applicable federal, state or local laws. We are proud to support and encourage individuals with military experience (active, veterans, reservists, and National Guardsmen), as well as military spouses, to apply for job opportunities at CVS Health.

Top 20 Common Interview Questions

1. Tell me about yourself.
2. What are your strengths and weaknesses?
3. Why do you want to work for our company?
4. What experience do you have that makes you a good fit for this position?
5. What are your long-term career goals?
6. How do you handle stress and pressure?
7. Can you give me an example of a time when you had to resolve a conflict with a colleague?
8. What do you know about our industry/competitors?
9. How do you stay organized and manage your workload?
10. Can you describe a time when you had to think creatively to solve a problem?
11. How do you handle criticism or feedback?
12. What motivates you to perform at your best?
13. How do you prioritize tasks and manage your time effectively?
14. What do you think are the most important qualities for success in this role?
15. Can you describe your leadership style?
16. Can you walk me through your resume and explain any gaps or inconsistencies?
17. What do you think sets you apart from other candidates?
18. How do you handle ambiguity or uncertainty in a project?
19. Can you give an example of a time when you had to adapt to a new situation quickly?
20. What questions do you have for us?

It's important to prepare for these types of questions and think about how you can best showcase your skills and experience to demonstrate why you're the right fit for the job.