Aetna Associate Eligibility Consultant in Harrisburg, Pennsylvania

Req ID: 42760BR

POSITION SUMMARY

Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns. Maintains enrollment databases and coordinates electronic transfer of eligibility data.

Fundamental Components:

Responds, researches, and resolves eligibility and billing related issues involving member specific information. Works directly with clients, field marketing offices and local claim operations to achieve positive service outcomes. (*)

Monitors daily status reports assessing output for developing trends potentially impacting service levels. (*)

Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters. (*)

Partners with other team functions to coordinate the release of eligibility, plan structure and benefit information. (*)

Completes required set-up of policy and eligibility screens in order to activate system processing of plan benefits. (*)

Ensures that legislation and compliance has been properly adhered to with regard to Plan Sponsor and member activity.

Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal and external support areas involving any requests for ID card customization. (*)

Completes data entry requirements for finalizing new enrollment information as well as for changes and terminations. (*)

Exhibits the following Manager Behaviors

BACKGROUND/EXPERIENCE desired:

Customer Service experience 1-3 years is REQUIRED.

Effective organization skills and attention to detail.

Maintain great working relationships with sound judgment and responsibility.

Effective communications, organizational, and interpersonal skills.

Demonstrated problem solving skills

Ability to analyze and research data to make appropriate corrections as necessary.

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

Functional - Customer Service/Customer Service - Plan Sponsor - Enrollment - HMO/1-3 Years

Functional - Customer Service/Customer Service - Plan Sponsor - Enrollment - Traditional/1-3 Years

TECHNOLOGY EXPERIENCES

Technical - Operating Systems/Windows/1-3 Years/End User

ADDITIONAL JOB INFORMATION

Effective organization skills and attention to detail.

Maintain great working relationships with sound judgment and responsibility.

Effective communications, organizational, and interpersonal skills.

Demonstrated problem solving skills

Ability to analyze and research data to make appropriate corrections as necessary.

. Prior Medicare experience is preferred

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Customer Service