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Customer Service Representative

Company: Aetna
Location: Toney
Posted on: January 16, 2022

Job Description:

Job Description* This is a Inbound Customer Service Associate Work from Home position.* $1000 sign on bonus* Receives inbound calls from members or providers regarding medical precertification* Sedentary work involving significant periods of sitting, talking, and data entry.* Work requires close attention to detail to accurately follow job aids and online resources.* Utilizes multiple Aetna systems to research and review member information for eligibility and benefits and build precertification cases when required.* Performs non-medical research including eligibility verification, Coordination of Benefits, and benefits verification.* Maintains accurate and complete documentation of required information.* Utilizes effective verbal and written communication, both internally and externally, to provide first call resolution and solve complex issues.* Protects the privacy of member information and adheres to company policies regarding confidentiality.* Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures.Required Qualifications* At least 1 year of inbound call center experience required.* Experience with medical terminology such as medical office assistant, billing and coding, previous experience with a health insurance company or other clinical experience.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.* If you are 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 within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.* If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.Preferred QualificationsHealth Insurance ExperienceEducationHigh School Diploma or G.E.D.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.

Keywords: Aetna, Huntsville , Customer Service Representative, Sales , Toney, Alabama

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