Aetna Sr Claim Benefit Spec in Lansing, Michigan

Req ID: 50799BR

POSITION SUMMARY

Sr. Claim Benefit Analyst, process Medical claims, including UB Facility, HCFA Professional, Vision, Surgeries, etc.

FUNDAMENTAL COMPONENTS

Analyzing claims on a DOS claim paying system, Medical, Vision, Medicare, Medicaid.

Run reports, manage inventory for groups assigned.

Production environment with high Quality expectations.

Communication with Client Services and other internal processes.

Also will work with Stop Loss/Reinsurance.

BACKGROUND/EXPERIENCE

2+ years claim processing experience or equivalent experience with Customer Service, billing/coding.

Experience in a production environment.

Claim processing experience is beneficial but not necessary.

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

EDUCATION

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

LICENSES AND CERTIFICATIONS

Claims/ is desired

FUNCTIONAL EXPERIENCES

Functional - Claims/Claim processing - Medical or Hospital - ACAS/1-3 Years

Functional - Claims/Policies & procedures/1-3 Years

Functional - Claims/Claims Administration - subrogation/1-3 Years

TELEWORK SPECIFICATIONS

Full-Time Telework (WAH) or in the Lansing, MI office

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: Claim