Aetna Bilingual - Outbound Call / Survey Representative, FL MCD in Doral, Florida

Req ID: 53467BR

POSITION SUMMARY

This position places outbound calls that are predominantly routine in nature, but may require deviation from standard scripts and procedures based on individual account situations. Utilizes system applications for tracking, information gathering and/or troubleshooting.

Fundamental Components:

  • Researches member files using a variety of systems and references to obtain appropriate background information used in conducting First Call Resolution surveys; answers questions and resolves issues related to survey calls.

  • Records survey responses in the First Call Resolution (FCR) Access Database. Ensures FCR reports in the database are maintained and resolved.

  • Performs service recovery for the member and documents actions taken and required follow-up to resolve situation.

  • Escalates issues accordingly when further action requires secondary sources or more senior staff.

  • May process claims or take inbound calls when applicable/authorized.

  • Collects and provides data to management for root cause analysis improving FCR/SAT for developing trends not captured through the FCR database.

  • Completes all required documentation in the database associated with survey input (including reason codes, complaints, etc.).

  • Documentation efforts also include MSW / HMO Event tracking.

BACKGROUND/EXPERIENCE desired:

  • Ability to read, write and speak in Spanish is a must

  • Experience in a production environment.

  • Customer Service experiences in a transaction based environment such as a call center or retail location preferred.

  • High School or GED equivalent.

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

ADDITIONAL JOB INFORMATION

Additional Information (competencies, skills, requirements, etc.) Analytical skills. Ability to maintain accuracy and production standards. Technical skills. Oral and written communication skills. Problem solving skills. Negotiation skills.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidates'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.

Job Function: Customer Service

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.