Aetna Reimbursement Services Claim Processor in Grand Rapids, Michigan

Req ID: 49191BR



The Reimbursement Claim Processor assists in administering FSA, HRA, wellness, commuter, fitness, tuition, etc. benefit plans and provides customer service to participants.

Fundamental Components:

Utilize administrative procedures and computer systems to perform daily tasks.

Display strong customer service skills (via email, phone, in person) to maintain integrity of the business.

Front-line service for participant phone calls, voicemail and email.

Escalate complex correspondence and/or issues to Account Manager.

Correspond with participants to correct errors or omissions on claim forms and investigate questionable items/services.

Adjudicate claims by comparing data on reimbursement form with participant receipts/documentation to determine completeness and validity of claim.

Enter claim data in system to pay participant according to reimbursement form, documentation submitted and the clients plan guidelines.

Research and resolve claim questions.

Assist with other duties as assigned.


Experience in a production driven environment of 1-3 years is REQUIRED.

Data Entry experience of 1-3 years is REQUIRED.

Experience with claims processing and/or benefits administration preferred

Excellent written and verbal communication skills; ability to listen, clarify and respond well to questions

Ability to operate and make timely decisions in an ambiguous, fast paced atmosphere

Must possess a passion for teamwork, client service and reaching business results through problem solving


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


General Business/Applying Reasoned Judgment/FOUNDATION

Service/Demonstrating Service Discipline/FOUNDATION

Technology/Leveraging Technology/FOUNDATION


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.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Health Care