Job Description
Welcome to Aetna, where we are committed to creating a healthier world by providing innovative and high-quality healthcare solutions. We are currently seeking a driven and experienced Supervisor to join our Claim Operations team at Aetna International. In this role, you will be responsible for overseeing the day-to-day operations of our claims processing department, ensuring accuracy and efficiency in the handling of claims. We are looking for a leader who is passionate about delivering exceptional service to our members and can effectively manage a team to achieve departmental goals. If you have a strong background in claims management and are looking for a challenging and rewarding opportunity, we invite you to apply for this position.
Oversee the day-to-day operations of the claims processing department to ensure timely and accurate handling of claims.
Develop and implement efficient processes to improve claims processing and enhance the overall customer experience.
Monitor and analyze department metrics to identify areas for improvement and implement necessary changes.
Train, coach, and mentor team members to ensure high-quality work and adherence to company policies and procedures.
Conduct performance evaluations and provide regular feedback to team members to promote growth and development.
Collaborate with other departments, such as customer service and provider relations, to resolve escalated issues and ensure a seamless claims process.
Stay updated on industry changes and regulations related to claims processing and ensure compliance within the department.
Develop and maintain relationships with key stakeholders, including providers and members, to ensure effective communication and problem resolution.
Monitor claim inventory and ensure timely processing to meet departmental and company targets.
Prepare and present regular reports on departmental performance and provide recommendations for improvement.
Identify and implement cost-saving initiatives to increase efficiency and reduce expenses.
Foster a positive and collaborative work environment, promoting teamwork and a high level of morale among team members.
Handle complex and sensitive member inquiries and complaints, ensuring prompt and satisfactory resolutions.
Maintain confidentiality of sensitive information and adhere to all company policies and procedures.
Participate in special projects and initiatives as assigned by upper management.
Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
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