Aetna Supervisor, Claims Operations in Singapore, Singapore
Req ID: 55897BR
Achieve superior claim and member service performance through an integrated process of operational, quality, medical cost, and resource management meeting and/or exceeding member, plan sponsor, and provider expectations.
Responsible for the overall supervision of the Claim administrative employees. Accountable for member/provider/broker satisfaction, retention, and growth by efficiently delivering competitive services to members/providers
Fundamental Components & Physical Requirements include but are not limited to (* denotes essential functions)
Develops, trains evaluates and coaches staff/self to provide good claim administrative service while ensuring quality standards are metActs as liaison between staff and other areas, including management, plan sponsors, provider teams, etc., communicating workflow results, ideas, and solutionsAssesses individual and team performance on a regular basis and provides candid and timely developmental feedback. Develops training plans and ensures training needs are metEstablishes clear vision aligned with company values; motivates others to balance customer needs and business successAttracts selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals. Builds a cohesive team that works well togetherProactively analyzes claim/constituent data, identifies trends and issues. Recognizes and acts on the needs to improve the development and delivery of products and services. Clearly identifies what must be accomplished for the successful completion of business objectivesLeverages the unit's resources to resolve plan, claim and call inquiries or problems by identifying the issue, obtaining applicable information, perform root cause analysis, and generate and act upon the solutionsManages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported; ensures resources are aligned appropriately across function and/or service centerEffectively applies and enforces HR policies and practices, Attendance, Code of Conduct, Disciplinary GuidelinesEnsures regulatory compliance with policies and proceduresSupports Complaints process as requiredUtilizes available incentive programs to reward, recognize, and celebrate team and individual's successAllocates resources to meet volume and performance standards including Key Performance Metrics (KPM's) and Performance GuaranteesInitiates and maintains partnerships with others throughout the organization and various vendorsEnsures compliance with the requirements of regional compliance authority/industry regulatorAdheres to international privacy policies, practices, and procedures
· 3+ years claims processing experience. Experience with claim/call center environment.
Education and Certification Requirements
Higher education or local market equivalent.University/college degree preferable or equivalent work experience.
Technical skills. Negotiation skills. Well organized. Prioritizes tasks effectively. Problem-solving skills. Outstanding customer service skills are required. Strong project management skills (financial, analytical, planning and implementation). Solid written and oral communication skills. Solid leadership skills including staff development
Job Function: Claim
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.