Aetna Customer Service Consultant (Claims) - 50170BR in Singapore, Singapore
Req ID: 50170BR
Summary/MissionTo increase member satisfaction, retention, and growth by efficiently delivering competitive services to members and providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.Position Summary/MissionHandles “claims centric customer service inquiries and problems via telephone, internet or written correspondence. Act as a subject matter expert by providing training, coaching, or responding to complex issues. Handle customer service inquiries and problems. Acts as end-to-end contact for clients experiencing claims related service problems. Fundamental Components & Physical Requirements include but are not limited to: · Professionally manage inbound and outbound telephone, fax and email correspondence with customers, brokers, suppliers and all other interested parties ensuring that appropriate and timely communication is maintained at all times.· Complete eligibility verification, escalate medical information to Clinical Case Managers, determine coverage, identify discrepancies, and apply all cost containment measures including identification of opportunities for subrogation and recovery.· Investigate claims for possible abuse and fraud.· May facilitate training and coaching when considered topic subject matter expert.· Escalate unresolved claims complaints and high costs claims to Service Delivery Leader for guidance.· Continually work to improve best practices procedures and standards.· Ensure compliance with requirements of regional compliance authority/industry regulator.· Adheres to international privacy policies, practices and procedures.· Strives to deliver consistently excellent customer service internally and externally.To take ownership of and responsibility for high-level customer enquiries politely and efficiently on the telephone and over email within boundaries of knowledge, ensuing that claims process is as smooth as possible. · Email queries and telephone calls to be actioned within 24-48 hours· Develop and maintain high-profile working relationships with business partners, providers, brokers and agents, to the highest level of customer service possible. · To promote the best image for the company through the professional appearance and behaviour and adhere to company standards and procedures. To maintain the highest level of personal conduct. Background/Experience Desired· Proven telephone / email-based customer service experience.· Highly beneficial to have worked in an insurance environment.· Ability to work in a fast paced, customer service environment with strong attention to details. Education and Certification Requirements· Clinical qualification would be highly beneficial but not essential· Fluent in English language communication skillsAdditional Information · Working knowledge of Word, Excel, Email and Internet.· Competent typist.· Excellent customer service skills with a strong command of written and spoken English.· Good communicator with strong organizational and problem-solving skills.