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Senior Customer Service Consultant, Hong Kong (Member Assistance Team - MAT)

Primary Location: Hong Kong, HKG
Additional Locations: HKG-Hong Kong

Family Summary / Mission

The global operations team is responsible for delivering world-class service to our members, internal customers, and providers. We are the face of Aetna and provide support, front line customer services, claims, and product expertise.

We believe that a positive member experience starts with investment in our people. Our aim is to communicate with our customers on their terms, through local teams, in local languages. We want to know our customers, own our relationships with them, predict their needs and meet them proactively. We ensure our members get the healthcare they need, when they need it, with maximum value and minimum effort.

Position Summary/Mission

The Senior Customer Service Consultant (MAT) role operates within our multi-channel Customer Centers to respond to customer requests and support customers with the administration of their insurance plan, enabling them to access healthcare anywhere in the world.

At Aetna, our leaders are naturally caring and empathetic, in addition to being keen problem solvers who take ownership of customer needs using their extensive knowledge, training, expertise, and passion to navigate customers through their healthcare journey.

As a senior consultant (MAT) in the Customer Service team, you will use your experience and natural problem-solving skills to tackle more complex cases and be a point of escalation for other members of the team. You may be asked to deputize for the Regional MAT Supervisor and undertake some of the supervisory tasks within your team. This position requires a high level of responsibility.

You will enjoy developing your skills in a variety of ways, including:

  • Professionally manage inbound & outbound telephone calls and email correspondence with customers, brokers, network providers, and all other interested parties ensuring that appropriate and timely communication is maintained.
  • Complete eligibility verification, work closely with Clinical Case managers where appropriate, determine coverage, identify discrepancies, and apply cost containment measures, all whilst maintaining a customer-centric approach.
  • Responsible for bringing Aetna International’s medical management policies and procedures to life, in a customer-centric fashion.
  • Triage and prioritize caseloads considering urgency, geographical location, service required, and customer expectations.
  • Deputize for Regional MAT Supervisor in terms of staff supervision, work allocation, case escalation, complaint management, and service recovery, when asked.
  • Take ownership for the progression of caseloads and support colleagues in the management of their caseloads by providing clear advice and direction to remove barriers and delays.
  • Working with your cross-functional peers with a constant view to improving the E2E member experience.
  • Responsible for meeting Operational SLAs, customer satisfaction objections and key financial goals.

The Regional MAT Supervisor will be encouraged and expected to cross-train and understand other responsibilities across our operations teams – leading to a broader skillset, a better member experience, and greater personal development opportunities.

The Role:
As the Senior Customer Service consultant (MAT), you will;
  • Have knowledge, skills, and experience in a variety of Operational disciplines and processes, with knowledge of medical terminology, and medical case management.
  • Display excellent oral and written communication skills.
  • Demonstrate the importance of active listening and be able to role model professional and caring behaviors.
  • Establish relationships with internal and external customers.
  • Act proactively, take ownership of problems and be empowered to take action to resolve our member's concerns.
  • Be resilient and adaptable. We work in a fast-paced environment with changing priorities, distressed customers, and at times high volumes of work and/or time-sensitive deadlines. Our employees must be able to thrive in this kind of environment.
  • Make sound financial decisions in sometimes urgent or ambiguous situations, putting the customer first whilst upholding and adhering to Aetna International's policies and procedures.

Responsibilities will include;
  • Be a subject matter expert and a point of escalation for more complex queries.
  • Play a leading role in the Regional team to ensure GOP and Enquiry volumes are turned around within SLA
  • Explain plan benefits and relate them to the customer inquiry.
  • Ensuring compliance with international and regional policies, practices and procedures.
  • First-line complaint resolution.
  • Always thinking about how to make your job better, faster, easier to improve the experience for our members. Proactively make suggestions and take the initiative to participate in and make changes happen.

  • Educated to A-level, secondary or pre-university level of education or higher. Equivalent qualifications and/or experience may be considered.
  • Experience in an insurance and/or healthcare environment is essential. Clinical qualification would be beneficial but not essential.
  • Demonstrable success in a customer-facing role for a minimum of 2 years prior.
  • Fluent written and spoken English with the second language being desirable.
  • Previous Healthcare/Insurance/Supervisory experience a plus.

Life experiences, traveling the world, living or working overseas, gap years, parenthood, healthy lifestyles, mentoring, volunteering – all these things help you to relate to our customers and are a plus.

Personal Attributes
You’ll need to demonstrate the following:
  • A passion for providing outstanding customer experience. Excellent listening skills.
  • An ability to solve complex challenges. Self-motivation with an ability to work on your own initiative.
  • Effective collaboration and team working. A high degree of accuracy and a keen eye for detail.
  • High levels of organizational skills with the ability to prioritize and multi-task.
  • The desire to make things better. And the ability to ask questions or seek clarification if you need help or are unclear.
  • Eager to work in high energy, fast-paced business, where change is a constant.

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


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