Client Services Specialist II

Agent Services Call Center Representative

Position Summary
As a Customer Service Representative, you play a vital role in shaping the agent experience and serving as a trusted resource for Aetna products and services. You will assist agents through phone, email, internet, and written correspondence, addressing questions, resolving issues, and providing guidance tailored to their individual needs.
In this role, you will engage, educate, and support agents by helping them navigate Aetna plans, tools, and resources while delivering exceptional service experiences. Calls and inquiries are often complex and may require critical thinking, problem-solving, and flexibility beyond standard procedures to meet agents\' unique needs effectively.
You will serve as a primary point of contact for field sales teams and customers, providing product knowledge and agent service support that contributes to agent success in the Medicare market. This position offers the opportunity to build strong relationships, support sales growth, and collaborate with a team that values learning, development, and service excellence.
Our department is known for its positive culture, commitment to growth, and supportive team environment. If you are customer-focused, eager to learn, possess a strong work ethic, and enjoy helping others succeed, we encourage you to join our team and make a meaningful impact.

Key Responsibilities
Develop and maintain expertise in Aetna\'s Medicare and senior market products to effectively support agents and customers.
Provide guidance and support on sales-related inquiries, helping agents navigate products, processes, and opportunities.
Utilize multiple software applications simultaneously to manage agent interactions, document activities, and ensure accurate recordkeeping.
Build and maintain strong, collaborative relationships with field sales representatives, brokers, consultants, and customer support teams.
Assist agents in navigating and utilizing agent support tools, websites, and self-service resources to enhance their experience and efficiency.
Process sales orders, fulfillment requests, and marketing material requests accurately and efficiently.
Support the onboarding, training, and mentoring of new and existing team members as needed.
Partner with supervisors and managers to provide operational support and contribute to team success.
Collaborate with cross-functional departments to identify opportunities for process improvements and drive positive changes that enhance service delivery.
Proactively identify agent needs and educate agents on available tools, resources, programs, and self-service capabilities designed to improve their overall experience.
Serve as a subject matter expert by providing guidance on policies, procedures, systems, and department processes.
Accurately document, track, and follow up on agent interactions, inquiries, and resolutions using established systems and processes to ensure a seamless service experience.

Required Qualifications
Customer Service - 1-3 Years of Experiences
Strong Analytical Skills
Basic computer skills
Insurance Knowledge Plus
Critical Thinking
Multi-Tasking
Written and verbal communication are necessary skills. 

Top 3 Required Skills
1. Communication and Interpersonal Skills
Ability to read, understand, and interpret instructions, correspondence, and other business communications.
Strong verbal and written communication skills with the ability to effectively present information to customers, agents, and colleagues in both one-on-one and small group settings.
Capable of building positive relationships while delivering professional, courteous, and customer-focused service.

2. Customer Service, Problem Solving, and Decision Making
Skilled in managing inbound and outbound interactions while providing exceptional support and service.
Ability to assess situations, identify solutions, and make sound decisions in a timely manner.
Provides education, guidance, issue resolution, and support to agents, customers, and internal partners.
Demonstrates a strong commitment to meeting customer needs and creating positive service experiences.

3. Organization, Multitasking, and Technical Proficiency
Effectively manages multiple tasks, priorities, and cases in a fast-paced environment.
Maintains accurate and detailed documentation of customer interactions and case activities.
Proficient in navigating multiple software applications and systems simultaneously.
Strong attention to detail and organizational skills, ensuring accuracy, efficiency, and follow-through on all work activities.

Work Schedule & Location
Location: Onsite @ Franklin 1021 Reams Fleming (Office) (TN3004)

Work Arrangement:
Onsite required 3 days per week
Flexible regarding which days are onsite

Schedule:
Monday through Friday
8:00 AM 5:00 PM CT

Safety Sensitive Position: Yes

Physical Demands
May sit, stand, stoop, bend, and walk intermittently throughout the day.
Ability to sit or stand for 7 to 10 hours per day.
May be required to work extended hours when business needs dictate.
Finger dexterity sufficient to operate office equipment.
Ability to occasionally lift up to 25 pounds.
Visual acuity required for reading fine print and detailed information.
Specific vision abilities include:
Close vision
Color vision
Ability to adjust focus
Must be able to hear normal conversational voice levels.

Work Environment
Climate-controlled office environment.
Smoke-free workplace.
Environment characteristics are representative of those encountered while performing the essential functions of the position.

Pre-Screen Questions
Attach Responses at the Top of the Resume
1. Insurance Experience
Which insurance types have you directly worked with
Examples:
Commercial
PBM
Medicare Parts A, B, C, and D
LIS (Low-Income Subsidy)
Specialty Pharmacy
Please list each type and briefly describe your experience.

2. Phone-Based Customer Service Experience
How many years of phone-based customer service experience do you have
Please include the types of calls handled, such as:
Inbound calls
Outbound calls
Case support
Benefit questions
Prior authorizations
Appeals
Patient or provider support

3. Systems & Software Experience
What systems or software have you used for benefit verification or case documentation
Examples:
Salesforce
CRM tools
Case management platforms
NaviNet
Payer portals
Pharmacy management systems

4. Multitasking & Documentation Experience
Do you have experience managing multiple cases or tasks simultaneously while maintaining accurate documentation
If yes, please provide a brief example describing:
The volume of work managed
How you prioritized tasks
How you ensured documentation accuracy and compliance.

Duties
Key Responsibilities: Solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing. Ability to work in a fast paced environment, handling both inbound and outbound calls. Must be organized, detail-oriented and able to document cases clearly and accurately in accordance with the program guidelines. Good communication skills are essential, both internal and external. Knowledge of Medicare benefits, enrollments and LIS assistance. Plans and organizes work assignments, set priorities and completes work with a minimum of supervision. Adheres to the service policy and principles of the company, as well as the program guidelines set by the department. Participates in cross-training to perform all roles within the department. Communicates effectively and professionally with our program partners to assure the best possible service for our patients and partners. Other duties as assigned. Physical Demands: May sit, stand, stoop, bend and walk intermittently during the day. May sit or stand seven (7) to ten (10) hours per day. May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Visual acuity to see and read fine prints. Specific vision abilities required by this role include close vision, color vision and the ability to adjust focus. Must be able to hear normal voice sounds. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role. Work Environment: Work in a climate-controlled, smoke-free internal environment.

Experience
Minimum (Required) Qualifications: (must be met in order to perform the job at the required level) Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization Knowledge of Business Blocks and CPR%2B Preferred Qualifications: Minimum of three (3) years work experience in applicant patient areas

Position Summary
Work with a team of specialists dedicated to one of our manufacturer partners to provide reimbursement support services. Have direct interaction with the manufacturer client to provide case statuses and updates.

Education
Associates degree in related field or equivalent experience is required.

What days & hours will the person work in this position List training hours, if different.
Monday - Friday 8am - 5pm CT