Primary Location: Phoenix, AZ Additional Locations: AZ-Phoenix Apply
Description: This position supports the Medicaid Encounter processes including new plan implementations, system upgrades, and regulatory changes by plan. Performs research and analysis to meet business/clients needs. Gathers and documents business requirements into specifications for system changes with management support.
Prepare, validate, submit, load, and log 837 encounter files and 277, 824, 999, NCPDP response files in accurate and timely manner according to state and federal regulations.
Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
Performs ongoing research, and support tasks for existing systems.
Provides workgroup support on projects.
May lead or act as a business expert with the planning, development and validation of detailed test plans and test scripts
837, 277, 999 encounter file preparation and correction experience.
Extensive experience with databases as well interpretation and manipulation of related data.
Strong organizational skills.
Knowledge of all types of managed care products.
Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook) and Internet Explorer.
Required Skills: General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, Technology - Selecting and Applying Technology Solutions Desired Skills: General Business - Applying Reasoned Judgment, General Business - Maximizing Work Practices, General Business - Turning Data into Information, Service - Providing Solutions to Constituent Needs Functional Skills: Administration / Operation - File Maintenance, General Management - Data analysis & interpretation, General Management - Project management (non-IT) 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. 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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