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For your reference, we have included the original job posting below.
Claim Benefit Specialist
Job Number:
43832411
Company Name:
Aetna
Job Location:
Ft Wayne, IN US
Job Category:
Accounting & Finance
Claim Benefit Specialist
Claim Benefit Specialist Job Group Claim Auto req ID 6348BR Locations IN-Ft Wayne Percent of Travel Required 0 - 10% Potential Telework Position No Full or Part Time Full Time Supervisory No Pay Opportunity Min $28,750 Pay Opportunity Max $29,500 Bonus Potential Variable % Job Description EXTERNAL CANDIDATES: Go to apply for this OTclick on the "apply to job" RENT EMPLOYEES: Continue.
POSITION SUMMARY Reviews and adjudicates routine claims in accordance with claim processing guidelines. Claim Benefit Specialists have the opportunity to enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims. You will be a key link in providing our customers with prompt, efficient, high quality claim service. Specifically, you will:
Review claims information to determine the nature of a members illness or injury Determine and understand the coverage provided under a members plan Efficiently utilize multiple systems to obtain and record claim information Make claim payment decisions Proactively make outbound calls to providers for additional information to make correct claim payment Identify claim cost management opportunities and refer claims for follow up Work to enhance customer satisfaction and retention Assist team members in support of achieving team, office, regional, and national goals
EDUCATION The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
FUNCTIONAL EXPERIENCES Claims/Claim processing - Medical or Hospital - ACAS/1-3 Years
TECHNOLOGY EXPERIENCES Desktop Tools/Microsoft Outlook/1-3 Years/End User Operating Systems/Windows XP/1-3 Years/End User
ADDITIONAL JOB INFORMATION We are looking for a customer focused individual who enjoys working in a team environment and can create value by anticipating and exceeding customer expectations. The ideal candidate will have exceptional analytical skills, accurate and fast keyboarding skills, advanced computer navigation and knowledge with experience in a Windows environment, effective verbal and written communication skills, the ability to adapt quickly and willingly to change, and a positive, willing attitude. Prior claim processing experience is a plus.
Successful candidates will be comfortable with quality goals, production goals and service expectations and will be monitored for accuracy, efficiency, and customer satisfaction. Comprehensive training will be provided to assist in the achievement of these objectives. Overtime may be required, based on business needs.
Clarification on Telework: existing/current Telework arrangements may be considered. New opportunities not available at this time.
Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
EXTERNAL CANDIDATES: Go to apply for this OTclick on the "apply to job" RENT EMPLOYEES: Continue.
