Complaint & Appeal AnlyPrimary Location: Phoenix, Arizona
Additional Locations: AZ-Phoenix Apply
- 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.
- 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.
1-2 years behavioral health experience. Medicare and Medicaid experience desired. Customer service (phones) a plus.
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
LICENSES AND CERTIFICATIONS
Mental Health/ is desired
Customer Service/ is desired
Customer Service/ is desired
Functional - Customer Service/Call center monitoring & analysis - Inbound calls - call center location/
Functional - Clinical / Medical/Direct patient care (hospital, private practice)/
Technical - Aetna Applications///
Technical - Desktop Tools///
Technical - Database///
ADDITIONAL JOB INFORMATION
Rewarding position within a department of bright individuals who work cohesively.
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.
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