Proven track record at Aetna, enhancing team performance and member satisfaction through expert problem-solving and effective communication. Leveraged organizational skills and technology know-how to streamline processes, achieving significant improvements in quality standards. Excelled in collaborative environments, demonstrating exceptional time management abilities.
Assist team in meeting quality expectations. Review calls and find opportunities for improvement. Support the team in finding strategies to succeed in their goals. Coach team members to support any challenges they may be facing. Implement new tactics to fuel change when needed.
As part of the MAC team I provide support to our members. If a member has an ongoing issue that was unable to be resolved in a single call I provide support to implement a swift resolution for the member. I reach out to the members and make sure that they have been assisted and act as a liaison for any issue that needs further work and then implement tools and coordination with others to find the member a solution.
As a Sr Service Advocate I was on the ISM team. This was a specialized team that was crossed trained in Medical, Dental and Pharmacy benefits making us a single stop to assist members in finding care, helping with claims and finding benefit coverage no matter which branch of care they were calling for all while providing quality care that met company standards.
As a health concierge I helped provide phone support for medical benefits. I helped members find health providers, file appeals, understand their coverage, connect with precertification and help with claims related issues.