Aetna Claims Supervisor in Farnborough, United States
Req ID: 51401BR
Aetna International is a leading provider of international expatriate private medical insurance and health management solutions. We have over 1000 staff and growing every day. Our customer base is over 123,000 members located worldwide; and we have more than 71,000 health care professionals and facilities worldwide in the offices in all the major regions of the world .
Responsible for the overall supervision of the Claim administrative employees. Accountable for member/provider/broker satisfaction, retention, and growth by efficiently delivering competitive services to members/providers
Responsibilities of the Role
• Develops, trains, evaluates, and coaches staff/self to provide good claim administrative service while ensuring quality standards are met
• Acts as liaison between staff and other areas, including management, plan sponsors, provider teams, etc., communicating workflow results, ideas, and solutions
• Assesses individual and team performance on a regular basis and provides candid and timely developmental feedback. Develops training plans and ensures training needs are met
• Establishes clear vision aligned with company values; motivates others to balance customer needs and business success
• Attracts, selects, and retains high calibre, diverse talent able to successfully achieve or exceed business goals. Builds a cohesive team that works well together
• Proactively analyses claim/constituent data, identifies trends and issues. Recognizes and acts on the needs to improve the development and delivery of products and services. Clearly identifies what must be accomplished for successful completion of business objectives
• Leverages the unit's resources to resolve plan, claim and call inquiries or problems by identifying the issue, obtaining applicable information, perform root cause analysis, and generate and act upon the solutions
• Manages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported; ensures resources are aligned appropriately across function and/or service centre
• Effectively applies and enforces HR polices and practices, Attendance, Code of Conduct, Disciplinary Guidelines
• Ensures regulatory compliance with policies and procedures
• Supports Complaints process as required
• Utilises available incentive programs to reward, recognize, and celebrate team and individual's success
• Allocates resources to meet volume and performance standards including Key Performance Metrics (KPM's) and Performance Guarantees
• Initiates and maintains partnerships with others throughout the organization and various vendors
• Ensures compliance with requirements of regional compliance authority/industry regulator
• Adheres to international privacy policies, practices and procedures
• Exhibits behaviours outlined in Claim Supervisor Competencies
• Previous experience leading teams as a Supervisor or Manager
• Experience within a claim/insurance environment.
• University degree preferable or equivalent work experience.
Additional Information (situational competencies, skills, work location requirements, etc.)
• Technical skills.
• Negotiation skills.
• Well organised.
• Prioritises tasks effectively.
• Problem solving skills.
• Outstanding customer service skills are required.
• Strong project management skills (financial, analytical, planning and implementation).
• Solid written and oral communication skills.
• Solid leadership skills including staff development
Job Function: Claim