Customer Service Rep

73962BRJob Description:Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. Customer inquiries are of basic and at times complex nature. Engages, consults and educates members based upon the member’s unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care.Req#:73962BRJob Group:Customer ServiceFull or Part Time:Full TimeSupervisory Responsibilities:NoPercent of Travel Required:0 - 10%Posting Job Title:Customer Service RepresentativePotential Telework Position:NoAdditional Locations:TN-FranklinPrimary Location (City, State):TN-FranklinEEO Statement:Aetna is an Equal Opportunity, Affirmative Action EmployerResource Group:1Additional Job Information:Ability to multi-task to accomplish workload efficiently. Oral and written communication skills. Ability to maintain accuracy and production standards. Negotiation skills. Technical skills. Problem solving skills. Attention to detail and accuracy. Analytical skills.Fundamental Components:Answers questions and resolves issues based on phone calls/letters from members, providers, and agents. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and agents. The CSR guides the member through their members plan benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines. Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health. Taking accountability to fully understand the member’s needs by building a trusting and caring relationship with the member. Anticipates customer needs. Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc. Uses customer service threshold framework to make financial decisions to resolve member issues. Explains member's rights and responsibilities in accordance with contract. Processes account changes and maintenance, and complaints (member/provider/agent). Handles incoming calls from agents, providers and members on accident and health (A&H) and Final Expense policies. Works closely with claims processors and medical review team for one call solution. Offers high-quality customer service.Background Experience:Customer Service experiences in a fast-paced production environment such as high volume call center preferred. Demonstrating ability to be empathetic and compassionate Basic computer and Microsoft skills a must. Must be able to navigate through multiple systems simultaneously. Must be able to use reasoned judgement to resolve issues and be able to multi-task. Typing experience a must. High Candidate should have good written and oral skills.Benefits Program:Benefit eligibility may vary by position.Candidate Privacy Information:Aetna takes our candidate'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.Clinical Licensure Required:N/A