Hong KongDescription : Family Summary / MissionActs as an Advocate for, and support, the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of work processes in claim processing and / or customer service that impact customer satisfaction, medical cost management, and operational efficiency.
Consult and / or work cross functionally to influence and promote change in order to continually deliver quality service to our internal and external customers.
Position Summary / MissionPerforms call and email quality audits for ROW service operations for Open Health Plus / Actisure.
Fundamental Components & Physical Requirements include but are not limited to : Conduct standard quality reviews / audits to measure compliance with published policies, procedures, customer and regulatory guidelinesIdentify and distribute errors to business partnersAssist with the day-
to-day maintenance and operations of assigned functional unitPerform analysis of data to identify and communicate trends during day to day workMay perform or assist with special projects / reviewsMay provide technical or subject matter expertise concerning policies, procedures, and function-
related applications / systems toolsConduct continuous quality improvement initiatives and processing quality hoursBackground / Experience Desired1 -
3 years of claim processing and / or customer service experience.Education and Certification RequirementsHigh school diploma or equivalent.
61615EEO Statement : Aetna is an Equal Opportunity, Affirmative Action Employer