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Aetna Customer Service Representative in Houston, Texas

Req ID: 65534BR

Job Description

Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Service Programs. Promotes/supports quality effectiveness of Healthcare Services within a structured high volume Call Center environment.

Fundamental Components included but are not limited to:

Provide comprehensive healthcare management to facilitate delivery of appropriate quality healthcare, promote cost effective outcomes and improve program/operational efficiency involving clinical issues.

Qualifications Requirements and Preferences:

Experience in a fast paced high volume inbound call center and strong customer services skills are required. Ability to understand and articulate clinical documentation and notes. Medical terminology is preferred. Strong computer skills, experience in a Windows based environment and the ability to use multiple systems simultaneously to search out information. Excellent attendance & punctuality is essential. Ability to problem solve and independently deescalate difficult calls by recognizing/investigating the issue and asking the appropriate questions. Ability to adapt to change and be comfortable in a fast paced structured environment.

Functional Skills:

Customer Service - Customer service - production environment

Required Skills:

General Business - Communicating for Impact, Service - Creating a Differentiated Service Experience, Service - Demonstrating Service Discipline

Desired Skills:

General Business - Maximizing Work Practices, Service - Providing Solutions to Constituent Needs, Service - Working Across Boundaries

Additional Job Information:

Effective communication, telephonic and organization skills. Familiarity with basic medical terminology and concepts used in care management. Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Ability to effectively participate in a multi-disciplinary team including internal and external participants.

Benefit Eligibility

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

Job Function: Healthcare

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.