Aetna Customer Support Remote Jobs Work From Home

About the Role

Aetna, a CVS Health company and one of the largest health insurance providers in the United States, is hiring Remote Customer Support Representatives to serve its millions of health plan members from home. You will be the caring, knowledgeable voice that members rely on when they have questions about their health coverage, claims, and care options.

This full-time remote role comes with comprehensive benefits, structured paid training, and a real opportunity to build a long-term career in healthcare customer service. You do not need a clinical background — just a genuine desire to help people navigate their health plan and a professional communication style.

What You Will Do

• Handle inbound calls from Aetna health plan members regarding their benefits, coverage limits, and claims status
• Guide members through understanding their Explanation of Benefits, deductibles, co-pays, and out-of-pocket maximums
• Process prior authorization and referral requests and follow up on pending cases to provide timely updates
• Assist members in locating in-network providers, specialists, and urgent care facilities in their area
• Maintain accurate and thorough case notes in Aetna CRM systems after every single member interaction
• Escalate urgent medical, clinical, or complex case issues to nursing or case management teams promptly

Requirements

• High school diploma — some college coursework or healthcare administrative background preferred
• 1 or more years of customer service experience — health insurance, pharmacy, or healthcare background is a plus
• Empathetic, patient communication style appropriate for members dealing with health or financial stress
• Ability to navigate multiple computer systems and manage data entry simultaneously during calls
• Home PC with Windows 10 or above, USB headset, and a 25+ Mbps wired internet connection
• Quiet, private home workspace that meets Aetna remote work compliance standards

Pay and Benefits

• Pay: $16.00 to $20.00 per hour
• Full-time remote position with a structured shift schedule
• Medical, dental, and vision insurance — Aetna employees get premium health coverage
• 401(k) retirement plan with Aetna employer match
• Paid time off, sick leave, and observed US public holidays
• Career advancement into senior customer care, case management, and operations roles