Aetna Paper Eligibility Consultant in Phoenix, Arizona

Req ID: 38063BR

POSITION SUMMARY

Under general supervision, you will verify 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.

Fundamental Components include, but are not limited to:

Responds, researches, and resolves eligibility and/or billing related issues involving member specific information; Works directly with clients, field marketing offices and/or local claim operations to achieve positive service outcomes. Monitors daily status reports assessing output for developing trends potentially impacting service levels Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization. Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations. When necessary, reviews and corrects transaction errors impacting eligibility interfaces and prepares eligibility/enrollment information for imaging.

BACKGROUND/EXPERIENCE desired:

2-3+ years of Medicaid experience; Preference 1-2+ years of experience AHCCS; Preference Excel and Word Proficient with data manipulation comfort; Required1-2+ years of CMS (Center for Medicare and Medicaid services); Preference2-3+ years of Data Entry; Plus 2-3+ years+ customer service experience; Required

EDUCATION

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

FUNCTIONAL EXPERIENCES

Functional - Customer Service//1-3 Years

Functional - Administration / Operations//1-3 Years

Functional - Information Technology//1-3 Years

TECHNOLOGY EXPERIENCES

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

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

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

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

REQUIRED SKILLS

General Business/Managing Sales Relationships/FOUNDATION

General Business/Maximizing Work Practices/ADVANCED

Leadership/Collaborating for Results/FOUNDATION

ADDITIONAL JOB INFORMATION

Aetna is transforming health care to create healthier communities, a healthier nation, a healthier world. We want health care to work for you. Our focus and incentives are aimed squarely at a healthier you.

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: Customer Service