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Complaint and Appeal Analyst

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
This position includes receiving incoming calls from members who desire to file a complaint, grievance, or appeal with the Grievance, Appeals, and Member Grievance department.​ This position includes speaking with members who may be distressed or in crisis while capturing their complaint and documenting it accurately.

Fundamental Components:
  • Position requires taking incoming calls from members desiring to file a complaint with the Grievance, Appeals, and Member Grievance departments.
  • Position requires handling callers who are distressed or in crisis, and working with the member to resolve issues when appropriate.
  • Position requires strong writing skills with the ability to capture information from the caller accurately
  • 75% of time receiving incoming calls from members; calls could be regarding acute care or behavioral health.
  • 25% documenting the call accurately, composing and sending emails and letters.

Background Experience:
  • 1-2 years behavioral health experience.
  • Medicare and Medicaid experience preferred. Customer service (phones) a plus.

Additional Job Information:
Rewarding position within a department of bright individuals who work cohesively.

Required Skills:
General Business - Communicating for Impact, General Business - Consulting for Solutions, Leadership - Anticipating and Innovating, Leadership - Collaborating for Results

Functional Skills:
Customer Service - Call center monitoring & analysis - Inbound calls - call center location

Potential Telework Position:

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by 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.


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