Aetna Validation Analyst- Encounters in Phoenix, Arizona
Req ID: 63995BR
This position supports the Medicaid Encounter processes including new plan implementations, system upgrades, and regulatory changes by plan. Performs research and analysis to meet business/clients needs. Gathers and documents business requirements into specifications for system changes with management support.
Fundamental Components included but are not limited to:
Prepare, validate, submit, load, and log 837 encounter files and 277, 824, 999, NCPDP response files in accurate and timely manner according to state and federal regulations.
Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
Performs ongoing research, and support tasks for existing systems.
Provides workgroup support on projects.
May lead or act as a business expert with the planning, development and validation of detail test plans and test scripts.
Qualifications Requirements and Preferences:
837, 277, 999 encounter file preparation and correction experience.
Extensive experience with databases as well interpretation and manipulation of related data.
Strong organizational skills.
Knowledge of all types of managed care products.
Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook) and Internet Explorer.
Information Management - Data acquisition, data management, programming and documentation
General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, Technology - Selecting and Applying Technology Solutions
General Business - Applying Reasoned Judgment, General Business - Demonstrating Business and Industry Acumen, General Business - Maximizing Work Practices
Additional Job Information:
Fast paced, technical and highly regulated area.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Healthcare
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.