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: Bethlehem, Pennsylvania
Additional Locations: PA-Bethlehem Apply
63777Fundamental Components: - Health Concierge’s (HC’s) create an emotional connection with our members by understanding and engaging the member to the fullest. HC’s build a trusting relationship with the member by taking accountability to fully understand the members’ needs.
- Identify member needs beyond the initial inquiry by answering the unasked questions. HC’s answers questions and resolve issues as a ‘single-point-of-contact’ based on phone calls, letters, emails, Internet, chat and outreach programs from members.
- They make financial decisions to resolve member issues using customer service threshold framework.
- Collaborate with colleagues and co-workers to deliver a world-class member experience.
- The HC guides and educates the member through various elements of their benefit plan information and available services created to enhance the overall customer service experience.
- HC’s take ownership and resolve issues without or with limited management intervention. They have knowledge of Aetna policy, procedure and resources to comply with regulatory guidelines.”
Other activities may include:
- Answers questions and resolves issues as a “single-point-of-contact” based on phone calls, plan sponsors, PSS/ISO, members and providers.
- Provides customized interaction based on customer preference and individualized needs, 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 with the member.
- Anticipates customer needs.
- Provides the customer with related information to answer the unasked questions.
- Uses customer service threshold framework to make financial decisions to resolve member 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.
- Responds quickly to meet customer needs and resolve problems while avoiding over-committing, providing claim status information, benefit coverage interpretations, and explaining plan eligibility.
- Processes claim referrals and escalates issues as appropriate for grievances and appeals. Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction.Partners with other departments to deliver client specific presentations.
- Coordinates efforts both 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 customer in mind and central to all interactions.
- Collaborates with colleagues and co-workers to deliver a world class customer experience.
- May participate in preparation and presentation of client specific presentations.
- Coaches, trains and assists in the development of call center staff, as required.
- Participates in and/or leads special projects/initiatives addressing service issues, as necessary.
Background Experience: To be successful, HC require strong ability to multitask, 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, strong listening and organizational skills 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.”
Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate. Effective organizational skills and ability to manage multiple tasks. Effective communication skills, both verbal and written Additional Job Information: Our customer service area is the very important first line of contact with the customers. They work with members, providers and plan sponsors to help them understand our products and services. HC’s provide a human connection when it is needed most. Our customer service team consists of talented, dedicated people with the skills to make a difference in the lives of our customers. The setting is fast-paced and customer satisfaction is a top priority. People who thrive in our organization can handle multiple tasks while maintaining positive and professional outlook. Our work environment is engaging and diverse. Employees are encouraged to satisfy professional ambitions, take pride in their contributions and share in our success.”
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 - retail 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: 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. Click here to review the benefits associated with this 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.
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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