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.
What makes a successful Customer Service Representative? Here are the traits we are looking for:
- Good listener
- Problem Solver
- Quick thinking
Paid Time Off & Disability
Aetna’s Social Compact
Our commitment to improve wages and medical benefits.
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
Health Concierge - Customer Service RepresentativePrimary Location: Albany, New York
Additional Locations: NY-Albany Apply
- 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-contact’based 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.
- 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.
- 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.
Aetna has been named to Fortune’s 2018 World’s Most Admired Companies list. The company was ranked No. 4 in the “Health Care: Insurance and Managed Care” category.
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