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Aetna Validation Analyst- Encounters in Phoenix, Arizona

Req ID: 63995BR

Job Description

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.

Functional Skills:

Information Management - Data acquisition, data management, programming and documentation

Required Skills:

General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, Technology - Selecting and Applying Technology Solutions

Desired Skills:

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

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.

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