Client Advocate is responsible for the full range of provider services, claim, and call quality. Client Advocates are Medicaid plan specific specialist that will build and nurture positive relationships between the health plan, providers and managers. Responsibilities also include attending health plan operation meetings, identify, trouble shoot and resolve claim/system/contract issues.
Provide world class service to our providers by responding to provider issues and inquiries that are received via the telephone
Review, research and respond to inquiries from Providers
Identify issues based on provider inquiries and elevate those issues management
Analyze database to identify problems / issues pertaining to claim processing.
Complete claim adjustments and/or claim processing upon request
Complete miscellaneous assignments/projects upon request.
Account Management experience and/or Plan Sponsor Service experience
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
General Business/Communicating for Impact/FOUNDATION
Leadership/Driving a Culture of Compliance/FOUNDATION
Service/Creating a Differentiated Service Experience/FOUNDATION
Leadership/Collaborating for Results/ADVANCED
Service/Demonstrating Service Discipline/ADVANCED
Service/Handling Service Challenges/ADVANCED
Option for telework will be evaluated after a certain period of employment
Consideration for current internal teleworkers (in any area)
ADDITIONAL JOB INFORMATION
Analyzes and investigates
Prioritize and organize own work to meet deadlines
Investigate non-standard requests and problems
Provide explanation and information to others on plan specific topics
Use pertinent data and facts to identify and solve a range of problems
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 candidates'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.