A1A Client Advocate - Customer Service
What is A1A
Aetna One Advocate is Aetna’s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors high-touch, high-tech member advocacy service which combines data-driven processes with the expertise of highly trained clinical and concierge member services. The mission of this model is designed to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna a CVS Health company in our journey to change the way healthcare is delivered today. We are health care innovators.
The Client Advocate will serve as a subject matter expert of complex claims, provider contracts and assisting front line staff with overall member inquiries
• Manage rework routing bin and provide coaching feedback to front line staff.
• Supports business needs for phone and chat coverage during peak volumes.
• Proactive approach to workload and able to demonstrate ability to balance assignments independently.
• Collaborates respectfully across the division, other departments, Providers and members
• Strong verbal and written communication skills.
• Solid skills in conflict resolution and maintaining confidentiality.
• Independent problem solving skills .
• Ability to identify root cause and prevent reoccurrence.
• Team player who will assist in the success of the pod in any way needed.
• Minimum of 1 year in current role.
• Minimum of 3 years of customer service experience.
• Minimum of 1 years of experience handling escalated issues and/or mentoring.
• Minimum of 1-3 years of claims knowledge.
• 3-5 years previous experience with Call Center/Claim environment is desired.
See items above
High School Diploma or G.E.D.
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.