Aetna Complaints Resolution Analyst, Hong Kong (Customer service role) #51350BR in Hong Kong, Hong Kong

Req ID: 51350BR

JOB DESCRIPTION Timely, accurate, customer-focused response to customer queries, complaints and appeals. Review and analysis of plan documents, company policies, internal processes and regulatory requirements in order to make decisions and recommendations as to how to improve our business and resolve issues.Develop and maintain strong collaborative relationships with many operational areas, including but not limited to Member Services, Claims, Plan Sponsor Services, Compliance, Legal, Complaints Grievance & Appeals and external vendors. Responsible for investigating and resolving complaint and appeal scenarios for the Actisure and Open Health business platform, which may contain multiple issues, and the co-ordination of a response that incorporates input from multiple business units, including external vendorsTrend analysis on issues and improvement areas. Recommended training and business solutions to continually improve our customer s experience with Aetna International.Work closely with the Aetna International Compliance Team to identify and analyze root causes of complaints, appeals and improvement areas.Responsible for producing management information for regulatory reports and senior management. Ability to ‘get underneath what is really going on to pull out customer insights.Produce timely reports and analysis statistics.Managing multiple assignments, accurately and efficiently. Build relationships, across several levels of the business, while coordinating with multiple business units.Identify trends and issues, and recommend business solutions.


Positive, can-do attitudeAble to work in high pressure situationsCustomer-centric mindsetLogical, Direct, and a belief that simple is always better


Excellent customer service skills including using proper service language, objection handling, and providing satisfactory solution.Ability to influence a variety of business areas to get good results for both our customer and the business.Excellent written and verbal communication skills. Strong presentation skillsStrong organization, co-ordination and prioritization skillsStrong analytical and problem-solving skillsGood utilization of Microsoft Office Software SKILLS AND EXPERIENCE REQUIREMENTS

4-5 years experience in customer service Previous experience in service recovery/complaint handling an assetWork experience in insurance industry an asset Proven excellent service by meeting quality and turnaround key performance metrics and meeting productivity expectations. Excellent letter writing skills to convey a positive, professional image with our internal and external customers is essential. Proven ability to produce and analyze complaint/appeal statistics and written reports relating to complaint handling, resolution and tracking. Demonstrate the ability to build a strong internal network and effective influencing skills in order to recommend resolutions within regulatory timeframes. Effective analysis skills to identify the complaint/service issue and recommend an appropriate resolution. EDUCATION

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.


Job Function: Risk Management

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.