Aetna Sr Claim Data Specialist in Tampa, Florida

Req ID: 48640BR


The Senior Claim Data Specialist will support the Meritain Adjustments and Recoveries team with projects, workflow and training. This role will serve as subject matter expert on adjustments and recoveries processes, assisting adjustments team members with detail questions and collaborating with other departments on adjustment requests and reporting.

Fundamental Components:

Performs as Subject Matter Expert for the team relative to complex set-up, processing, system, policies and/or department workflows, meeting internal/external deadlines for production and quality of various products and services. Mentors other employees associated with adjustment processes. Leads process improvement initiatives to improve productivity, accuracy and/or customer service and tool development. Manages assigned projects and ensures project plans and/or work tasks align with overall organizational goals. Works to prioritize and assign incoming work and monitors escalated requests.


Claims processing and/or claims adjustments experience. Highly organized and able to quickly prioritize multiple assignments with high quality results. Excellent written and oral communication skills. Ability to work collaboratively within work team. Strong customer service skills. Ability to interact with different groups of people at different levels and provide assistance on a timely basis.


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


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

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


Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/End User

Technical - Desktop Tools/Microsoft Word/1-3 Years/End User

Telework Specifications:

Considered only for current internal teleworkers (in any area)


Opportunity to work with a high quality team focused on improving operational processes for an overall better customer experience.

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