Aetna Provider Data Services (PDS) Analyst in Princeton, New Jersey

Req ID: 37641BR

POSITION SUMMARY

In this role you will maintain the Provider Data (demographic and contractual) for all network and non-network providers. You will ensure all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings). You will develop and maintain standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements.

Fundamental Components

Performs accurate and timely baseline demographic transaction updates in provider system applications in support of claim adjudication and Doc Findr

Performs intake triage and responds to network inquiries

Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers

Reviews provider maintenance requests for complete and accurate information

Contacts providers to clarify and resolve data quality issues

Identifies and appropriately escalates data transaction issues that mighty potentially have significant contractual implications or adversely impact service levels

Exhibits the following Provider Data Services Analyst Behaviors

BACKGROUND/EXPERIENCE

Highly organized and able to quickly prioritize multiple assignments with high quality results.

Effective communication skills, both verbal and written.

Solid PC skills, including Microsoft Office products and Internet navigation skills.

Microsoft Excel, Word and Outlook are a must! Proficiency in Excel to include pivot tables is important!

PDS experience would be preferred!

Proven ability to track information and prioritize multiple assignments.

Claims experience is preferred!

EDUCATION

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

ADDITIONAL JOB INFORMATION

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