At Aetna, we’re pioneering a total approach to health and wellness, focusing on the whole person - body, mind, and spirit. Our more than 4,000 nurses are central to turning our member’s health ambitions, big and small, into achievements. Your role will include helping members stay well, manage health conditions, and access the right care at the right time. As you do this, we’ll support you in achieving more in your life and your work.
What makes a successful nurse? Here are the traits we are looking for:
- Problem Solver
- Results Driven
- Technology Savvy
- Detail Oriented
- Good Listener
- Open Minded
- Team Player
Paid Time Off & Disability
Registered Nurse/Health Service ManagerPrimary Location: Blue Bell, Pennsylvania
Additional Locations: PA-Blue Bell Apply
- Provide policy and coding guidance for initiatives driven by Medical Policy & Program Solutions (MPPS) and Analytics & Behavior Change (ABC)
- Provide inpatient coding subject matter expertise by identifying coding opportunities in particular those involving DRGs and other inpatient pricing concepts.
- Identify potential waste and abuse by performing audits of inpatient medical records.
- Demonstrate the ability to assign accurate ICD-10 medical codes for diagnoses and procedures performed in an inpatient setting.
- Ability to integrate coding and reimbursement understanding with charge master updates
- Registered Nurse is required
- Inpatient coding certification is preferred
- Must be familiar with inpatient facility contracting/pricing methodologies and industry coding concepts
- Demonstrate basic knowledge of health insurance claim processing
- Good investigation skills are a plus
- Excellent verbal and written communication skills
- Comfortable using various databases and computer systems to research and investigate opportunities
Health hero Q&A
This Aetna nurse helps new moms overcome opioids.
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