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Eligibility Consultant-Paper

at Aetna (Fresno, CA) Full Time Tuesday, February 24th, 2009

Job Description:

ABOUT OUR COMPANY

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.

JOB GROUP SUMMARY

Customer Service is the important first-line of contact with customers, setting the tone for how members, doctors and plan sponsor groups view our company. It provides members with the right information at the right time to help them make better decisions about their health and health care.

POSITION SUMMARY

Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns. Maintains enrollment databases and coordinates transfer of non-electronic eligibility data. Responds, researches, and resolves eligibility issues. Monitors and works eligibility reports. Applies legislative/regulatory policies, account structure when addressing eligibility matters. In a production and quality environment, keys enrollment into our two eligibility systems meeting production and quality standards.

Qualifications:

EDUCATION

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

FUNCTIONAL WORK EXPERIENCE

- Customer Service: Customer service - production environment

- Customer Service: Customer Service Plan Sponsor Eligibility Traditional - Paper

- Customer Service: Customer Service Plan Sponsor Eligibility HMO - Paper

- Customer Service: Plan sponsor eligibility

REQUIRED SKILLS

- Anticipating and Innovating

- Collaborating for Results

- Conduct manual enrollment updates, including adds, changes, terminations, address updates, ID card requests, COB, Member Details for claims payments, HIPAA certificates etc

- Work Management

- Creating Accountability

DESIRED SKILLS

- Apply state and federal legislation and regulations

- Handling Service Challenges

- Interpersonal Communication

- Leveraging Technology

- Research and resolve eligibility related issues regarding member specific information

- Review and correct transaction errors impacting eligibility interfaces

Salary: 28,000

When to apply:

ASAP

How to apply:

www.aetnajobs.com
Employment
Position 27410

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