Be the voice members trust when they have questions about coverage, claims, and Medicare-related processes, in both English and Spanish. If you’re empathetic, sharp with details, and comfortable navigating multiple systems while you talk, this role is a strong remote lane.
About CVS Health (Aetna)
CVS Health is a leading health solutions company serving millions through local presence and digital channels. In this Aetna customer care role, you’ll support members, providers, and plan sponsors by resolving inquiries and guiding people through benefits, policies, and next steps.
Schedule
- Remote (available in 49 locations)
- Full-time, 40 hours/week
- Application window expected to close 12/20/2025
What You’ll Do
⦁ Answer and resolve member and provider inquiries by phone, online, or written correspondence
⦁ Consult and educate members on Aetna plans, tools, resources, and benefits navigation
⦁ Document and track contacts with members, providers, and plan sponsors
⦁ Triage rework to appropriate staff and coordinate referrals as needed
⦁ Process claim referrals, complaints, grievances, and appeals using target systems
⦁ Explain member rights and responsibilities in accordance with contracts and policy
⦁ Use service thresholds to make financial decisions to resolve member issues when appropriate
⦁ Support brokerage inbound calls (application status, contract/appointment status)
⦁ Help with commission inquiries, data entry, Medicare contract processing, appointments, and certification verification for external producers/agents
⦁ Assist with credentialing/re-credentialing questions and respond to litigation-related document requests when assigned
What You Need
⦁ Fluency in English and Spanish (required)
⦁ 6+ months customer service experience
⦁ Strong communication and empathy skills
⦁ Ability to navigate multiple systems and tools while supporting customers
⦁ High school diploma or GED
Benefits
⦁ Affordable medical plan options
⦁ 401(k) with company match and employee stock purchase plan
⦁ Wellness programs, confidential counseling, and financial coaching
⦁ Paid time off, flexible schedules, family leave, dependent care resources, colleague assistance programs, and tuition assistance (eligibility varies)
This one closes 12/20/2025, so don’t wait until the last minute and then get “mysteriously busy.”
If you’re ready to be the bilingual bridge between members and the care they’re trying to access, go apply.
Happy Hunting,
~Two Chicks…