Job Description: This is a full time telework position. Qualified candidates may reside in any state (US). The Senior Claim Data Specialist handles end-to-end processes associated with claim data management. Identifies and addresses issues impacting auto-adjudication levels and claim accuracy. May complete manual plan-set-up activities associated with new business/account implementations. Job Responsibilities: Assists with the development and testing of new or enhanced product offerings as assigned. Presents information effectively to various levels of employees and management through various formats, i.e. one on one, staff/customer meetings, presentations, etc. 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. Analyzes and determines if products and services selected by customers are aligned with their benefit needs and can be adequately supported through existing systems or operating platforms; alternately, seeks solutions and negotiate essential requirements in support of any non-standard plan selections. Provides supervisory back up and assists in the delegation of issues and proposes streamlined workload assignments. Mentors other employees associated with claim data management (e.g. provides technical expertise to team/unit). 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. Job Requirements: Excellent written and oral communication skills. Minimum of one year of recent and related direct customer service experience. Ability to manage multiple priorities. Proficiency in all claim platforms and/or products, i.e. Traditional, HMO, HNO. Ability to work collaboratively within work teams. Minimum three years recent and or related claim processing experience. Demonstrated proficiency with personal computer, keyboard navigation skills and with MS Office Suite applications. Job Details: Company: Aetna Vacancy Type: Full Time Job Location: Columbus, OH, US Application Deadline: N/A Apply Here careers-trivia.com
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