Aetna Provider Data Services Senior Analyst in Harrisburg, Pennsylvania

Req ID: 41952BR

POSITION SUMMARY

Maintains the provider data (demographic and contractual) for all network and non-network providers. Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e, directory listings)

FUNDAMENTAL COMPONENTS

  • Performs accurate and timely baseline demographic transaction updates in provider system applications in support of claim adjudication and Doc Finr.

  • Performs intake triage and responds to network inquiries, provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers.

  • Reviews provider maintenance requests for complete and accurate information.

  • Contacts providers to clarify and resolve data quality issues.

  • Identifies and appropriately escalates data transaction issues that might potentially have significant contractual implications or adversely impact service levels.

    BACKGROUND/EXPERIENCE DESIRED

  • Provider Data Services background (1-3 years) or Network background (1-3 years).

  • Demonstrated ability to handle multiple assignments competently, accurately and efficiently.

  • Demonstrated analytical skills - able to interpret data, translate it into meaningful information and draw conclusions.

  • Experience with relevant Aetna internal systems.

  • Demonstrated effective communication skills

    EDUCATION

    The minimum level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

    ADDITIONAL JOB INFORMATION

    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: Health Care