Customer Service Representative - Bilingual (Spanish)

Customer Service Representative - Bilingual (Spanish)

Empresa: CVS Health. We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary 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 nature. - Engages, consults and educates members based upon the member’s unique needs, preferences and under‐standing 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 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-ser‐vice tools, etc. - Uses customer service thresh‐old framework to make financial decisions to resolve member issues. - Explains member's rights and responsibilities in accordan