Jul 11, 2020

A1A Customer Service Advocate

  • Professional Diversity Network
  • New Albany, OH, USA
Intern Other

Job Description

Aetna

Description: Aetna One Advocate is Aetna's premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors high-touch, high-tech member advocacy service which combines data-driven processes with the expertise of highly trained clinical and concierge member services. The mission of this model is designed to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members' needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today. We are health care innovators.The schedule after training is Monday through Friday, any 8 hour shift between 10:30 am and 9 pm with rotating Saturdays and occasional holidays.71589 Fundamental Components: Consistently showcase a passion for health and helping people. Acts as a single-point-of-contact for the member. Explains member plan of benefits, member's rights and responsibilities in accordance with contracted arrangements, claim status information, benefit coverage, plan eligibility, dental, vision, pharmacy, HSA, provider details, care management, on-boarding, tool usage and available programs/resources. Own the members concerns all the way through to resolution no matter where that might take us. You will interact with providers, clinicians, pharmacists, and other professional's in an effort to provide total satisfaction and resolution for the member.Consistently seek to build trusting relationships with members by understanding their needs and health aspirations Deliver a suite of services to members that support easy navigation of the healthcare system, from providing personalized next best action recommendations, to maintaining individual data accuracy and integrity Assists the member in finding their health ambition * Connects the member with additional administrative and clinical resources as needed Uses proactive, predictive and preventative analytics to service members Provides high-quality, customer-focused telephonic service using knowledge of procedures and systems to meet and/or exceed customer satisfaction Coordinates with clinicians to compile the member's Care Plan and conduct adherence follow-up Works with case managers for members requiring urgent or emergent service, or services rendered in a setting other than a practitioner's office. This is an inbound and outbound call center position. Service Advocates are responsible for answering inbound calls regarding member's health care needs, while following up on commitments in a timely manner. Service Advocates will proactively make outbound calls to engage members and assist them along their health care Journey. Handle sensitive member information with discretion Prioritizes effectively to meet member service goals / deadlines Resolves member issues, while effectively making the right decisions for our members Collaborate with colleagues and co-workers to deliver a world class customer experience Background Experience: 3+ years' experience directly interacting with the public, delivering high touch, experiential interactions - preferably in a healthcare call center, ministry, education, military, retail, hotel/concierge , non-profit, financial services, travel agency, real estate or other customer advocate roleHigh School Diploma or G.E.D required - College degree or equivalent work experience strongly preferred Strong written & verbal communication skills requiredAbility to multi-task, prioritize and effectively adapt to a fast paced changing environment required Demonstrated organizational and communication skills required Intermediate typing skills - 50 WPM strongly desired Ability to seamlessly, multi-task while using multiple systems, to efficiently provide service to members Deep problem solving skills with demonstrated ownership of issue resolution Possess top-notch people skills - listening, caring, connecting, empathy, and supporting Highly perceptive individual with strong self-awareness and empathy in interacting with various audiencesDemonstrated propensity for responsiveness and a sense of urgency when helping members Demonstrated ability to uphold Aetna's values of caring, inspiration, integrity, and excellence in each member interaction and in building team cohesiveness Strong skillset in the use of the suite of Microsoft Office tools strongly desired Ability to work effectively in a team environment required Ability to learn and retain in a complex environment. Additional Job Information: Strong communications skills. Strong analytical skills focusing on accuracy and attention to detail. Computer literacy in order to navigate through internal/external computer systems. Understanding of medical terminology. Ability to maintain accuracy and production standards. Negotiation skills. Problem solving skills.Training hours for this class are 8:30am -5pm, Monday - Friday for 12 weeks.After training, each new employee will transition to a schedule that ends between 7pm - 9pm.Saturday rotation is required every 4 - 6 weeks. We have limited 2:30pm - 11pm shifts that come with a shift differential. Clinical Licensure: N/A Potential Telework Position: No 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.PDN-71589BR

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