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Aetna is now a CVS Health Company

Claim Reporting and Special Services Analyst

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
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Description:
This position will be part of the Check Run team. Processing weekly fee for service and monthly capitation check runs timely to ensure prompt provider payments for several health plans.

Fundamental Components:
This position will be part of the Check Run team. This will include but not limited to processing weekly fee for service and monthly capitation check runs timely to ensure prompt provider payments for several health plans. This position will also consist of completing positive pay for all check runs and verifying transmission to banks. Uses system produced data to prepare management level reports. Uses system output to monitor and/or reconcile specific line of business accounts and customer bank accounts. Monitors, reviews, researches, reconciles and balances designated Aetna system activity. Reviews and analyzes system reports and other information to develop financial information for use in reporting. Analyzes and recommends solutions to non-standard requests and requirements from plan sponsors and areas within and outside the area. Analyzes and verifies system results to ensure accuracy, accountability and financial data integrity. Possesses working knowledge of functions of other units in department. Responds to and resolves customer inquiries and complaints (internal as well as external) both verbal and written correspondence within established unit objectives.


Background Experience:
  • 1-3 years accounts payable/accounts receivable/payment processing experience preferred.
  • Knowledge of medical claim payment processing or account reconciliation is helpful.
  • Experience working as part of a team to meet established deadlines and resolve issues is required.
  • Attention to details and accuracy are essential skills.


Additional Job Information:
This position offers the opportunity to work with many different departments to support daily health plan payment activities and assist in the implementation of new health plans.

Required Skills:
General Business - Applying Reasoned Judgment, General Business - Communicating for Impact, Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance

Desired Skills:
General Business - Communicating for Impact, Leadership - Collaborating for Results, Leadership - Creating Accountability

Functional Skills:
Administration / Operation - Document production & distribution, Administration / Operation - File Maintenance, Claim - Payment management, Claim - Reporting & special services, Finance - Accounts receivable, Finance - Treasury services - bank reconciliations

Technology Experience:
Aetna Application - QNXT, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel, Reporting Tool - Crystal Reports / Crystal Enterprise

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 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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