A1A Customer Service AdvocatePrimary Location: High Point, NC
Additional Locations: NC-High Point Apply
65344Fundamental 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 role • High School Diploma or G.E.D required - College degree or equivalent work experience strongly preferred • Strong written & verbal communication skills required • Ability 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 audiences • Demonstrated 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: Our training hours are 800am - 430pm for 12 weeks. After training, work schedules range from starting as early as 10am and end as late as 9pm.
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