Aetna Health Concierge in Fresno, California
Req ID: 50305BR
Customer Service Representative is the face of Aetna and impacts members service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. Customer inquiries are of basic and at times complex nature. Engages, consults and educates members based upon the members unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care. Provides targeted, personalized service based on a holistic view of the member, benefits, health information, and through engagement. Handles customer service inquiries and problems via telephone, internet, web-chat or written correspondence. Engages, consults and educates members by delivering individualized programs based upon the members unique needs and preferences. Utilizes resources to assist customers in understanding components of the Aetna products including claims, accumulators, usage and balances, and cost sharing.
Answers questions and resolves issues as a single-point-of-contact based on phone calls, plan sponsors, PSS/ISO, members and providers. Provide customized interaction based on customer preference and individualized needs. 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 (i.e., assistance with Aetna Navigator, Consultation Opportunities Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc). Utilizes all relevant information to effectively influence member engagement. Proactively assesses customer issues and anticipates their needs. Based on the issues and customer needs, quickly determines if the member call should be extended. Takes immediate action when confronted with a problem or made aware of a situation
Customer Service experience in a transaction based environment.
Effective communication skills, both verbal and written
Effective organizational skills and ability to manage multiple tasks.
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Functional - Customer Service/Customer Service - Member Services - Traditional products/1-3 Years
Technical - Aetna Applications//1-3 Years/End User
Service/Creating a Differentiated Service Experience/FOUNDATION
Service/Providing Solutions to Constituent Needs/FOUNDATION
ADDITIONAL JOB INFORMATION
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 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.
Job Function: Customer Service