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Provider Data Svcs Anly

Primary Location: Woodland Hills, CA
Additional Locations: CA-Woodland Hills
As a Dental Network Representative with Aetna, you will perform intake triage and respond to Dental Network inquiries including but not limited to: • Provider requests (e.g., policy and procedures, credentialing status, claims status, provider compensation, directories, etc.) • Internal customer requests • Member requests Additionally, you will provide ongoing support to department members in completing research and analysis to resolve concerns/issues raised by providers and other internal/external customers

Fundamental Components:
Perform data entry and systems maintenance as needed • Support production and distribution of provider communication and educational materials • Obtains delegated credentialing materials and coordinates processes • Align data across all systems verify, analyze and maintain all provider data in support of claim adjudication and production of directory • Review provider maintenance request for complete and accurate information • Provide feedback to claim processors, customer service representatives and other staff (e.g., appropriateness of request, accurate completion of provider add/change forms) • Internal/external production control; tracking and reporting for all maintenance requests • Develop and/or produce system queries/reports • Provide education and training to providers and/or internal customers on systems related policies and procedures

Background Experience:
Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Strong analytical and written/oral communication skills. Associates or BS degree or 0 to 2 years experience directly related to the duties and responsibilities specified or an equivalent combination of education and work experience.

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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