Aetna Health

  • Fresno, CA, United States

Finding the cure for the common health care system

Aetna is about more than just doing a job. This is our opportunity to re-shape health care 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 and our customers. We are inspired to make a difference, and we are committed to integrity and excellence. Together we’ll empower people to live healthier lives. 

Aetna is an equal opportunity and affirmative action employer- People of Color, Women, Veterans, and Individuals with Disabilities.

$30,000 - $60,000 yearly
Aetna Health San Francisco, CA, USA
Jun 24, 2019
Full time
Req ID: 49625BR POSITION SUMMARY Administratively support the Northern California Middle Market Account Management and Sales Team. Fundamental Components: The sales support role will work closely with the Rep to assist them with plan sponsor and broker requests/issues. Process requests for proposals, claim, billing, enrollment, commissions, order kits, provide word processing support including spreadsheets, presentations, reports and other documents with a high degree of speed and accuracy and generally supporting the account management team to ensure the accounts are serviced well. Respond professionally to telephone calls and emails. Assist in the upkeep of the case files. Using knowledge of Aetna's organization, policies and procedures to maximize effectiveness as a resource for customers. Strong emphasis on supporting and promoting teamwork and keeping management informed of areas where processes may be improved. BACKGROUND/EXPERIENCE desired: General office skills (typing, filing, phone skills, etc.) required Proficiency in MS Word, Excel & Outlook required Insurance background is highly preferred Excellent time management and prioritization skills Be able to work independently as well as part of a strong team Salesforce experience preferred Strong communication skills are a must Candidate must be a quick learner with a positive attitude EDUCATION The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Sales & Service/Sales administration, support, reporting/1-3 Years Functional - Administration / Operations/Document production & distribution/1-3 Years REQUIRED SKILLS General Business/Communicating for Impact/ADVANCED General Business/Maximizing Work Practices/ADVANCED Sales/Delivering on the Promise/ADVANCED DESIRED SKILLS General Business/Turning Data into Information/ADVANCED Service/Case Administration/FOUNDATION Service/Improving constituent-focused Processes/ADVANCED ADDITIONAL JOB INFORMATION We are looking for a self-starter who sees what needs to get done & gets it done right the first time. The ideal candidate works well in a team environment & thrives on variety, efficiency & challenge. The successful candidate will possess the ability to handle multiple tasks simultaneously, change priorities as needed. This person willingly takes ownership and accountability for own actions in support of customer requests, stay on top of daily tasks meeting required turn around times & follow them to resolution. If you like a challenging environment with opportunities to learn and advance - this is a great job for you. This is an entry level position and an excellent way to get into the sales organization with growth opportunities. Located in our San Francisco office, no Telework available. 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 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.       Team C Gary Munson
$30,000 - $45,000 yearly
Aetna Health Fresno, CA, USA
Jun 24, 2019
Full time
POSITION SUMMARY Provides 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 by delivering individualized programs based upon the members unique needs and preferences. Utilizes resources to assist customers in understanding components of the Aetna products including claims, accumulators, usage and balances, and cost sharing. Fundamental Components: A Health Concierge answers questions and resolves issues as a single-point-of-contact based on phone calls from plan sponsors and members. We provide a customized interaction based on customer preference and individualized needs. Takes ownership of each customer contact to resolve their issues and connect them with additional services as appropriate and responds quickly to meet customer needs and resolve problems while avoiding over-committing. A Health Concierge takes immediate action when confronted with a problem or made aware of a situation and identifies member needs beyond the initial inquiry by answering the unasked questions. Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service and works collaboratively with colleagues to deliver the best customer experience. 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 Aetna Navigator, Consultation Opportunities Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc). 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. May participate in preparation and presentation of client specific presentations. 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 High School diploma, G.E.D. or equivalent experience. FUNCTIONAL EXPERIENCES Functional - Customer Service/Customer Service - Member Services - Traditional products/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 Technical - Desktop Tools/Microsoft SharePoint/1-3 Years/End User REQUIRED SKILLS Service/Demonstrating Service Discipline/ADVANCED Service/Handling Service Challenges/ADVANCED Service/Providing Solutions to Constituent Needs/FOUNDATION DESIRED SKILLS Leadership/Creating Accountability/FOUNDATION Leadership/Driving a Culture of Compliance/FOUNDATION Service/Creating a Differentiated Service Experience/FOUNDATION ADDITIONAL JOB INFORMATION Our Government Services team is hiring Health Concierge to support growth in our Public Sector & Labor membership. 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. Must be able to work an 8-hour shift between 7:00 AM to 7:00 PM, Monday through Friday, schedules may rotate. Excellent attendance and punctuality are requirements of this position. 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.     Team C Gary Munson
$40,000 - $56,000 yearly
Aetna Health Fresno, CA, USA
Jun 24, 2019
Full time
Req ID: 50419BR POSITION SUMMARY Successful candidates are organized, strong attention to detail, and customer service focus. Fundamental Components: Our Sales Support Consultants help our brokers and customers and internal team with activities related to renewals, plan changes, administrative and general sales support processes. BACKGROUND/EXPERIENCE desired: Experience with salesforce.com is a plus. Experience with Excel, Word, and Microsoft Office software necessary. EDUCATION The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION 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 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.       Team C Gary Munson
$16.00 - $20.00 hourly
Aetna Health Sacramento, CA, USA
Jun 14, 2019
Full time
Description: Handles provider customer service inquiries and problems via telephone, internet or written correspondence. Customer inquiries are of basic and routine nature. 59906 Fundamental Components: - Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. - Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors. The CSR guides the member through their members plan of 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 claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. - Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues. - Responds to requests received from Aetna's Law Document Center regarding litigation; lawsuits - Handles extensive file review requests. Assists in preparation of complaint trend reports. Assists in compiling claim data for customer audits. - Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. - Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. - Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary. - Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received. Background Experience: - Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate. - Experience in a production environment. Additional Job Information: Experience in a production environment. Customer Service experience in a transaction based environment such as a call center or retail location preferred Ability to multi-task to accomplish workload efficiently. Understanding of medical terminology. 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. Required Skills: Leadership - Driving Change, Service - Working Across Boundaries Desired Skills: Service - Creating a Differentiated Service Experience, Service - Handling Service Challenges, Service - Providing Solutions to Constituent Needs Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position.         Gary Munson\ https://www.aetnacareers.com/job/west-sacramento/customer-service-representative/41/12186076