Associate Claim Benefit Specialist-CorrespondencePrimary Location: Houston, Texas
Additional Locations: TX-Houston Apply
61998Fundamental Components: Processes paper claims and electronic work queues in accordance with company policies and procedures. Interprets and processes adjustments in accordance with company policies and procedures. Reviews basic pended claims to determine the appropriateness of the claim status. Researches customer information by effectively gathering documentation needed to process claims and adjustments and routes to appropriate department or queue. Examines information including, but not limited to, authorizations, payments, denials, coordination of benefits, and eligibility. Maintains production and claims quality standard. Takes responsibility for completing assignments and bringing all outstanding issues to closure. Maintains complete and accurate documentation. Demonstrates basic understanding of all products. Demonstrates responsiveness and a sense of urgency when dealing with customers. Proactively takes responsibility for own self-development. Demonstrates professionalism and presents a positive image of the company when interacting with customers. Supports individual and team goals and initiatives; accepts ownership for individual result. May interface with customers via telephone to respond to routine inquiries and resolve concerns on an as-needed basis. Performs other duties as required. Background Experience: Ability to absorb and apply new and changing information. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Effective verbal and written communication skills. Displays a positive, confident attitude; highly self-motivated and accountable. Strong listening and interpersonal skills; skilled at developing and maintaining effective working relationships. Responds positively to goal-setting and performance measurement. Effective keyboard skills; able to navigate within a computer/systems-dependent environment without assistance; previous experience in a windows-based computer environment preferred. Effective organizational skills and ability to manage multiple tasks. Demonstrated analytical and problem-solving skills. High School Diploma or equivalent. Required Skills: General Business - Applying Reasoned Judgment, General Business - Demonstrating Business and Industry Acumen, Service - Demonstrating Service Discipline Functional Skills: Administration / Operation - Data Entry Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Candidate Privacy Information: 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
Jobs for you
Recently Viewed Jobs
You do not have any recently viewed jobs
Your Saved Jobs
You do not have any saved jobs
Sign up for Job Alerts
Join our Talent Community
At Aetna, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna.
Join Our Talent Community
Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna.