Title Customer Service Team Lead
Position Summary Meritain Health, an Aetna company, has an opening for a Team Leader. This position handles customer service inquiries and problems via telephone, internet, or written correspondence. Acts as a subject matter expert by providing training, coaching, or responding to complex issues. May handle escalated customer service inquiries and problems. Acts as end-to-end contact for callers experiencing claim and/or customer service problems. Handles telephone and written correspondence from varied sources (members, providers, plan sponsors). Makes outbound calls if necessary for member/provider follow-up. Performs a wide variety of customer service related functions, including telephone calls, written inquiries, and out reach programs. Explains customer/member specific plan of benefits along with member's responsibilities in accordance with contracted arrangements. Assists customer service representatives with complex issues to promote first call resolution. Documents and tracks all member contacts, events, and outcomes via appropriate systems. Works to enhance provider satisfaction while balancing interests of plan sponsor and member; keeps abreast of all network nuances. Accesses information from a variety of systems and references including contracting and network system. Educates providers and members on our self service options. Monitors customer service representatives calls to ensure compliance with business quality standards. Assists management with special projects as assigned.
Required Qualifications - Functional Experience
- Customer service - production environment/4-6 Years
- Coaching and mentorship experience
- Technology Experience
- Technical - Desktop Tools - Adobe Acrobat Suite v5/1-3
- Technical - Desktop Tools - Microsoft Outlook/4-6 Years/End User
Preferred Qualifications - Experience in a production environment.
- Claim processing experience.
- Customer Service experience in a transaction based environment.
- Demonstrated ability to handle multiple assignments competently, accurately, and efficiently.
- Management: < 25 employees/4-6 Year
Education Associate's degree or equivalent experience
Business Overview 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.
Req ID 1578349BR
Clinical Licensure Required N/A
Job Category Aetna
Business Area Aetna
Job Type (Expected Hours Category) Full Time
Location - State/City FL - Tampa
Location code AO038
Street Address 4630 Woodland Corporate Blvd
City Tampa
State FL
Zip Code 33614
Country United States
FLSA Non Exempt
Requisition Template Professional
Sourcing Requisition No
No. of Positions 1