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Customer Service Representative

At Aetna, we’re pioneering a total approach to health and wellness, focusing on the whole person - body, mind, and spirit. Our customer service and claim teams provide a human connection when it’s needed most and are essential to turning our member’s health ambitions, big and small, into achievements. Your role will include processing claims and helping members, doctors, and companies better understand our products and services. You will be an advocate for our member’s best health by helping them get the most from their benefits, building trust and always providing a clear path to care.

  • Job Type: Full-time
  • Job Level: Entry Level
  • Travel: No

Aetna’s minimum starting salary is $16/hr.

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Success Profile

What makes a successful Customer Service Representative? Here are the traits we are looking for:

  • Trustworthy
  • Empathetic
  • Proactive
  • Compassionate
  • Good listener
  • Problem Solver
  • Communicator
  • Independent
  • Multi-tasker
  • Patient
  • Collaborative
  • Personable
  • Quick thinking
  • Enthusiastic

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  • Health

  • Paid Time Off & Disability

  • Financial

  • Wellness

  • Additional Benefits

  • Aetna’s Social Compact

    Our commitment to improve wages and medical benefits.

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Customer Service Representative Quotes

You really are invested in the member… you have to be their advocate.

Damon H., Senior Health Concierge Customer Service Representative

I’m very excited about the common purpose [Advocate for our members’ best health by helping get them most from their benefits, building trust and always providing a clear path to care], in the first day of training all the leaders came in and explained it. As soon as they got done talking I knew this was the company for me.

Emily E., Customer Service Representative

Job Details

Health Concierge - Customer Service Representative

Primary Location: Albany, New York
Additional Locations: NY-Albany
At Aetna, we are currently recruiting caring, compassionate andcuriousHealthConcierge Representativeswho are willing to be problem solvers and champions for our members’ best health to help guide the members along a clear path to care. We work to build trust with our members and take pride in doing the right thing for the right reason. If you are passionate and empathetic about the people you serve, this position may be a fantastic career opportunity for you!

Fundamental Components:
  • HealthConcierges (HCs)create an emotional connection with our members by understanding and engaging the member to the fullest.
  • HCsbuild a trusting relationship with the member by taking accountability to fully understand the members’ needs.
  • They identify member needs beyond the initial inquiry by answering the unasked questions.
  • HCs answerquestions and resolve issuesas a ‘single-point-of-contactbased on phone calls, letters, emails, internet, chat and outreach programsfrom members.
  • They make financial decisions to resolve member issues using customer service threshold framework.
  • They collaborate with colleagues and co-workers to deliver a world-class member experience.
  • The HCguidesand educatesthe member throughvarious elements oftheir benefitplan information and available services created to enhance the overall customer service experience.
  • HCstake ownership and resolve issues with or without limited management intervention.
  • Theyhave knowledge ofAetna policy, procedure andresources to comply with regulatory guidelines.

Background Experience:
  • To be successful,HCs requirestrong ability to multi-task, prioritize, problem-solve and effectively adapt to a fast-paced, changing environment.
  • In addition to excellent computer skills, top candidates will possess critical thinking, professionalism,stronglisteningand organizationalskills and demonstrate empathy.
  • A minimum of two years of Customer Service experience in a service environment, such as a call center or retail location preferred.

Additional Job Information:
Our customer service area is the very important first line of contact with the customers. They work withmembers,providers andplansponsors to help them understand our products and services.HCs providea human connection when it is needed most. Our customer service team consists of talented, dedicated people with the skills to make adifference in the lives of our customers. The setting is fast-pacedand customer satisfaction is a top priority. People who thrive in our organization can handle multiple tasks while maintaining positive and professionaloutlook.Our work environment is engaging and diverse. Employees are encouraged to satisfy professional ambitions, take pride in their contributions and share in our success.
  • Provides customized interaction based on customer preference, creating an emotional connection with our members by understanding and engaging the member to the fullest.
  • Fully understands the member’s needs by building a trusting and caring relationship.
  • Anticipates customer needs.
  • Uses customer service threshold framework to make financial decisions to resolve issues.
  • Educates and assists customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company.
  • Takes immediate action when confronted with a problem or made aware of a situation.
  • Takes ownership of each customer contact to resolve their issues and connect them with additional services as appropriate.
  • Identifies member needs beyond the initial inquiry by answering the unasked questions.
  • Provides education to members to support them in managing their health.
  • Providing claim status information, benefit coverage interpretations, and explaining plan eligibility. Escalates issues as appropriate through the system for grievances and appeals.
  • Initiates outreach/welcome calls to ensure constituent's expectations are met or exceeded.
  • Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems. Partners with other departments.
  • Coordinates efforts internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service.
  • Works collaboratively with colleagues to deliver the best customer experience. Seeks to understand the customer, including circumstances, problems, expectations and needs.
  • Asks probing questions to identify the underlying customer needs.
  • Guides members to the appropriate health resource.
  • Offers alternatives where appropriate. Acts with the best interest of the customer in mind and central to all interactions.

Required Skills:
General Business - Maximizing Work Practices, Service - Creating a Differentiated Service Experience, Service - Providing Solutions to Constituent Needs

Desired Skills:
Service - Demonstrating Service Discipline, Service - Handling Service Challenges, Service - Working Across Boundaries

Functional Skills:
Customer Service - Customer Service - Member Services - HMO products, Customer Service - Customer Service - Member Services - Traditional products, Customer Service - Customer service - production environment, Customer Service - Customer service - transaction based environment

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft SharePoint, Desktop Tool - Microsoft Word

Potential Telework Position:

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

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