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Customer Service Rep - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Bismarck, North Dakota |
About this job
POSITION SUMMARY
This Customer Service Representative (CSR) is a vital customer service person for the providers, such as hospitals and doctors, who care for our Aetna members. This position requires handling incoming complex service inquiries via telephone, internet or written correspondence. Our ability to handle these inquiries and claim adjustments in a positive manner ensure our providers and members are able to focus on health issues, not claim issues.
Fundamental Components:
As the service representative for our organization, a positive attitude, great listening skills, and excellent communication skills are a high priority. We expect excellent, efficient service on every call. We need CSRs who care about our members and providers.
CSRs are required to:
*Answer questions and resolve issues based on phone calls and correspondence from providers with a focus on first-call resolution.
*Document activities and triage work to appropriate areas; detail oriented to ensure accuracy.
*Educate providers on claim policies and procedures, member plan of benefits, grievance and appeal processes, self-service options, and other special topics as needed.
*Utilize several system applications to retrieve information, analyze information to answer questions and identify the root cause of a problem, calculate adjustments needed, and determine appropriate resolution.
*Demonstrate knowledge in health care and state legislation, call and claim policies, desktop systems, provider contract nuances, medical terminology.
*Display proficient computer skills with experience in a Windows environment; ability to use multiple screens during one transaction.
*Work independently and in a team environment with an emphasis on building a culture based on the Aetna values.
*Participate in ongoing training and engage in self-development to build skills.
*Commit to servicing our customers and being a part of a team - which means being at work is critical; i.e. good attendance is vital.
BACKGROUND/EXPERIENCE desired:
Excellent interpersonal and communication skills.
Personal passion to help people.
Customer service experience is a plus, but not always required.
Ability to solve problems.
Computer profiency.
EDUCATION
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
FUNCTIONAL EXPERIENCES
Functional - Customer Service//1-3 Years
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
REQUIRED SKILLS
Leadership/Driving a Culture of Compliance/FOUNDATION
Service/Demonstrating Service Discipline/FOUNDATION
Service/Providing Solutions to Constituent Needs/FOUNDATION
DESIRED SKILLS
General Business/Maximizing Work Practices/ADVANCED
Service/Creating a Differentiated Service Experience/ADVANCED
Service/Handling Service Challenges/ADVANCED
ADDITIONAL JOB INFORMATION
This position is a doorway to a career at Aetna. Many individuals learn the basics of the insurance industry in this role and obtain promotions to a number of different positions. The training and expertise you gain in this position will benefit you for the rest of your life as healthcare affects everyone. We will provide you training and support, along with outstanding benefits from Aetna, to help you succeed. Aetna's benefits include tuition allowance so you can also build your skills externally. We are looking for candidates who want to join our team and be a part of our future.
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Business Support & Technical
This Customer Service Representative (CSR) is a vital customer service person for the providers, such as hospitals and doctors, who care for our Aetna members. This position requires handling incoming complex service inquiries via telephone, internet or written correspondence. Our ability to handle these inquiries and claim adjustments in a positive manner ensure our providers and members are able to focus on health issues, not claim issues.
Fundamental Components:
As the service representative for our organization, a positive attitude, great listening skills, and excellent communication skills are a high priority. We expect excellent, efficient service on every call. We need CSRs who care about our members and providers.
CSRs are required to:
*Answer questions and resolve issues based on phone calls and correspondence from providers with a focus on first-call resolution.
*Document activities and triage work to appropriate areas; detail oriented to ensure accuracy.
*Educate providers on claim policies and procedures, member plan of benefits, grievance and appeal processes, self-service options, and other special topics as needed.
*Utilize several system applications to retrieve information, analyze information to answer questions and identify the root cause of a problem, calculate adjustments needed, and determine appropriate resolution.
*Demonstrate knowledge in health care and state legislation, call and claim policies, desktop systems, provider contract nuances, medical terminology.
*Display proficient computer skills with experience in a Windows environment; ability to use multiple screens during one transaction.
*Work independently and in a team environment with an emphasis on building a culture based on the Aetna values.
*Participate in ongoing training and engage in self-development to build skills.
*Commit to servicing our customers and being a part of a team - which means being at work is critical; i.e. good attendance is vital.
BACKGROUND/EXPERIENCE desired:
Excellent interpersonal and communication skills.
Personal passion to help people.
Customer service experience is a plus, but not always required.
Ability to solve problems.
Computer profiency.
EDUCATION
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
FUNCTIONAL EXPERIENCES
Functional - Customer Service//1-3 Years
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
REQUIRED SKILLS
Leadership/Driving a Culture of Compliance/FOUNDATION
Service/Demonstrating Service Discipline/FOUNDATION
Service/Providing Solutions to Constituent Needs/FOUNDATION
DESIRED SKILLS
General Business/Maximizing Work Practices/ADVANCED
Service/Creating a Differentiated Service Experience/ADVANCED
Service/Handling Service Challenges/ADVANCED
ADDITIONAL JOB INFORMATION
This position is a doorway to a career at Aetna. Many individuals learn the basics of the insurance industry in this role and obtain promotions to a number of different positions. The training and expertise you gain in this position will benefit you for the rest of your life as healthcare affects everyone. We will provide you training and support, along with outstanding benefits from Aetna, to help you succeed. Aetna's benefits include tuition allowance so you can also build your skills externally. We are looking for candidates who want to join our team and be a part of our future.
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Business Support & Technical