Aetna Claim Benefit Specialist in Pittsburgh, Pennsylvania

Req ID: 50450BR


The Claim Benefit Specialist position is a production based role servicing Medicare Advantage Beneficiaries.

Fundamental Components:

Reviews and adjudicates Medicare medical claims in accordance with CMS claim processing guidelines. Role requires strong keyboard skills, attention to detail and the ability to work independently in a production environment.


Experience in a production based environment with an emphasis on quality outcomes.

Medical Claim processing experience preferably supporting Medicare products.

Strong computer navigational skills.

Medical terminology and coding certification.


The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.


Functional - Claims/Claim processing - Medical - Medicare/1-3 Years


General Business/Maximizing Work Practices/FOUNDATION

Service/Providing Solutions to Constituent Needs/FOUNDATION

Service/Demonstrating Service Discipline/FOUNDATION


Service/Creating a Differentiated Service Experience/FOUNDATION

Technology/Leveraging Technology/FOUNDATION

General Business/Communicating for Impact/FOUNDATION


We are looking for highly motivated individuals to service our Medicare Beneficiaries. The Claim Benefit Specialist position is a production based role with an emphasis on quality outcomes.

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