Aetna Inb/Outb Queue Assoc in Phoenix, Arizona
Req ID: 38119BR
Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Service Programs, Promotes/supports quality effectiveness of Healthcare Services.
Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Service Programs, Promotes/supports quality effectiveness of Healthcare Services. The primary function of this position is to answer calls from our medical providers and to help them obtain prior authorizations for medical procedures for members. The representative will follow documented procedures and correctly complete the steps needed to allow for the procedure to take place and for a subsequent claim to be paid. This is a call center environment where each employee must meet certain goals concerning the handling of calls. Quality is also crucial to a successful performance.
Candidate should have experience working in a medical field environment, or insurance work with medical information. Prior Authorization experience would be preferred. Call center work or customer service experience also important. Candidate should be able to multitask and use multiple applications interchangeably. A positive attitude desired and the ability to learn complicated processes.
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
Functional - Customer Service/Call center monitoring & analysis - Inbound calls - call center location/1-3 Years
Functional - Medical Management/Medical Management - Precertification/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Benefits Management/Interacting with Medical Professionals/ADVANCED
General Business/Maximizing Work Practices/ADVANCED
Leadership/Driving a Culture of Compliance/ADVANCED
Service/Creating a Differentiated Service Experience/ADVANCED
Service/Demonstrating Service Discipline/FOUNDATION
Service/Providing Solutions to Constituent Needs/FOUNDATION
ADDITIONAL JOB INFORMATION
Knowledge of medical terminology and processes is critical to handling calls efficiently. The ability to work as a part of a team is critical to the success of both the individual and the team. A representative must also be open to change because newer technology, changes in benefits, and changes in processes happen rapidly in the medical field.
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.
Job Function: Health Care