Aetna Health Concierge in Jacksonville, Florida

Req ID: 55195BR

POSITION SUMMARY

Health Concierge is the face of Aetna to provide 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 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. Utilizes resources to assist customers in understanding components of the Aetna products including claims, accumulators, usage and balances, and cost sharing.

Fundamental Components:

  • 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 member self-service tools, 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.

  • Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility. Processing claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals.

  • Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded. Through in-depth analysis, identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction.

  • Partners with other departments to deliver client specific presentations. Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service. (*)

  • Works collaboratively with colleagues to deliver the best customer experience

BACKGROUND/EXPERIENCE desired

  • Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.

  • Effective communication skills, both verbal and written

  • Effective organizational skills and ability to manage multiple tasks.

EDUCATION

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

FUNCTIONAL EXPERIENCES

  • Functional - Customer Service/Call center monitoring & analysis - Inbound calls - call center location/1-3 Years

  • Functional - Customer Service/Customer service - Medical billing/1-3 Years

TECHNOLOGY EXPERIENCE:

Technical - Aetna Applications/Customer Service Inquiry/1-3 Years/End User

REQUIRED SKILLS

General Business/Applying Reasoned Judgment/ADVANCED

General Business/Communicating for Impact/FOUNDATION

Service/Providing Solutions to Constituent Needs/FOUNDATION

DESIRED SKILLS

General Business/Turning Data into Information/ADVANCED

Service/Improving Constituent-Focused Processes/FOUNDATION

ADDITIONAL JOB INFORMATION

  • In-depth knowledge of benefits program and system design (Health and Welfare, Wealth, other employee benefits), related financials, legal/regulatory requirements.

  • Strong negotiation and collaboration skills.

  • Strong analytical skills and innovative problem solving abilities.

  • Ability to maintain accuracy and production standards.

  • Technical skills.

  • Innovative Thinking and Change Agent - Looks for, identifies and acts on opportunities to improve how we design, develop, and deliver products and services.

  • Attention to detail and accuracy.

  • Empathy towards customers' needs and concerns.

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.