Aetna Provider Data Svc Sr Anly in Hartford, Connecticut
Req ID: 49157BR
Performs data entry of International Providers efficiently meeting department guidelines, metrics and audit policies. Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues.
Loads International Healthcare Providers into multiple systems meeting TAT expectations Researches International Provider payment issues for providers by reviewing set-up in multiple systems and resolving any discrepancies Researches returned checks to determine accurate mailing address Resolves discrepancies with EOBs Loads new, changes and banking updates for International Providers in multiple systems Researches International Providers on the Internet to determine accurate demographic information Assists with special projects and meet deadlines Maintains quality at 95%
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.
Provide ongoing business direction relative to provider data structures that are regional in scope in support of claims adjudication and directory production.
The minimum level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Functional - Network Management/Provider data services/1+ Years
Functional - Customer Service/FE Customer Service - Provider - Traditional/1+ Years
Technical - Aetna Applications/Actisure/1+ Years/End User
Technical - Aetna Applications/Enterprise Provider Database System/1+ Years/End User
Technical - Aetna Applications/Smart Front End/1+ Years/End User
Technical - Desktop Tools/Microsoft SharePoint/1+ Years/End User
General Business/Communicating for Impact/ADVANCED
General Business/Maximizing Work Practices/MASTERY
Leadership/Collaborating for Results/FOUNDATION
Service/Creating a Differentiated Service Experience/FOUNDATION
General Business/Turning Data into Information/MASTERY
Service/Providing Solutions to Constituent Needs/MASTERY
ADDITIONAL JOB INFORMATION
This position affords the opportunity for collaboration with cross-functional areas within the International organization, enhancement of relationship building skills and continuous learning.
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