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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Network Relations Spec

Primary Location: Columbus, Ohio
Additional Locations: OH-Columbus
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POSITION SUMMARY
This position will be focused on handling all aspects of providers services which includes contracting, credentialing, claims and provider updates. This position requires representatives to take inbound/outbound call from providers.

Fundamental Components:
  • Verify, analyze and maintain provider data in support of claim adjudication and production of directories.
  • Respond timely to provider/network inquires (Network Assistance Requests and phone/e-mail messages.)
  • Reviewing claims status and being able to follow the appropriate steps to resolve issues for providers.
  • Being able to navigate several systems for research.
BACKGROUND/EXPERIENCE desired:
  • Demonstrated ability to handle multiple assignments competently, accurately and efficiently
  • Claims Experience
  • Contracting and credentialing knowledge
  • Call center experience

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

FUNCTIONAL EXPERIENCES
Functional - Network Management//1-3 Years
Functional - Customer Service//1-3 Years
Functional - Claims//1-3 Years

TECHNOLOGY EXPERIENCES
Technical - Aetna Applications//1-3 Years/End User

ADDITIONAL JOB INFORMATION
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.

Click To Review Our Benefits (PDF)

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