Aetna Sr Eligibility Consultant in Winnabow, North Carolina

Req ID: 54403BR


Processes accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production (e.g., ID cards, billings, mailings, etc.). Ensures services and products meet the plan sponsors needs.

Fundamental Components:

Acts as the liaison between clients, vendors, and the IT department with defining business requirements associated with non-standard reporting; identifies potential solutions and approves programming specifications required for testing any non-standard arrangements. (*)

Delivers consulting services in support of data discrepancies and/or involving reporting alternatives. (*)

Responds to eligibility and other enrollment related issues involving member specific information; partners directly with clients, vendors, field marketing staff, and/or local claim operation to resolve problems and achieve positive outcomes. (*)

Assists with and/or evaluates recommendations involving electronic eligibility reporting solutions and negotiates with internal/external clients. (*)


Prefer 2-4 years data analyst experience

Attention to detail and accuracy.

Problem solving skills.

Understands the impact of work to other teams and downstream support areas.

Ability to analyze and research data to make appropriate corrections as necessary.

Sound understanding of system/data errors and how to resolve efficiently.

Strong organization skills.

Strong verbal and written communication skills.


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


Technology/Leveraging Technology/ADVANCED

General Business/Communicating for Impact/ADVANCED

Leadership/Anticipating and Innovating/MASTERY


Leadership/Collaborating for Results/MASTERY

General Business/Maximizing Work Practices/MASTERY

Leadership/Creating Accountability/MASTERY

Telework Specifications:

Option for telework will be evaluated after a certain period of employment


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 candidates'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: Customer Service

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.