Job Group Summary

Customer Service is the important first-line of contact with customers, setting the tone for how members, doctors and plan sponsor groups view our company. It provides members with the right information at the right time to help them make better decisions about their health and health care.

Family Summary/Mission

Manages and coordinates implementation for new and existing customers. Provides focused service for Individual and Group policies. Develop and maintain interpersonal relationships with external and internal customers.

Position Summary/Mission

Provide prompt, efficient data capture, prepare the required documentation, and member material to our members and Plan Sponsors.

Fundamental Components & Physical Requirements

Manages TAT & accuracy of processing of new business, renewals and mid-term adjustments. Audit quality control checks on processed policies. Manages customer records and ensure the records are adhere to company policies Establishes and maintains strong, collaborative relationships with clients, Brokers and other Aetna departments. Communicates effectively and timely to internal and external constituents Has proficiency of Aetna systems and is able to assimilate and translate relevant information on products and policies. Adhere to Best Practice Process, Service Standards and all relevant statutory or regulatory requirements. Manages and Maintains Case tracking tools to meet constituents and business goals. Provides tuition and training to the new staff. Acts as the Deputy Supervisor to assign tasks to the team members. Ensures the escalated cases could be properly handled. Ensures that legislation and compliance has been properly adhered to with regard to Plan Sponsor and/or member activity (FSA TCF and market specific requirements). Researches, responds and provides alternatives to inquiries from internal and external constituents to meet expectations. Ensures that products and services are aligned with customer’s requirements and commitments are met.

Background Experience Desired

  • Familiar with operation insurance process.
  • 5 years industry experience in a customer service role.
  • Has high end medical insurance background is a must.
  • Supervisory experience a plus.

Education and Certification Requirements
Bachelor degree holder, preferable in economic or insurance related major.

Additional Information

  • Strong verbal and written communication skills
  • Ability to multi-task to accomplish workload efficiently
  • Well organized
  • Strong customer focus
  • Problem solving skills
  • Process Improvement skill