Aetna Provider Data Services Analyst in Woodland Hills, California
Req ID: 50870BR
As a Dental Network Representative with Aetna, you will perform intake triage and respond to Dental Network inquiries including but not limited to: Provider requests (e.g., policy and procedures, credentialing status, claims status, provider compensation, directories, etc.) Internal customer requests Member requests Additionally, you will provide ongoing support to department members in completing research and analysis to resolve concerns/issues raised by providers and other internal/external customers
Perform data entry and systems maintenance as needed Support production and distribution of provider communication and educational materials Obtains delegated credentialing materials and coordinates processes Align data across all systems verify, analyze and maintain all provider data in support of claim adjudication and production of directory Review provider maintenance request for complete and accurate information Provide feedback to claim processors, customer service representatives and other staff (e.g., appropriateness of request, accurate completion of provider add/change forms) Internal/external production control; tracking and reporting for all maintenance requests Develop and/or produce system queries/reports Provide education and training to providers and/or internal customers on systems related policies and procedures
Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Strong analytical and written/oral communication skills. Associates or BS degree or 0 to 2 years experience directly related to the duties and responsibilities specified or an equivalent combination of education and work experience.
The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.
This position is mandatory in Woodland Hills office, with flexibility to work 2 days a week at home.
ADDITIONAL JOB INFORMATION
Dental Background in claim administration and ADA procedure codes is preferred Demonstrated ability to handle multiple assignments competently, accurately and efficiently Must work independently and meet deadlines Strong analytical and written/oral communication skills Associates or BS degree or 0 to 2 years experience directly related to the duties and responsibilities specified preferred
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