Req ID: 26209BR
POSITION SUMMARY
Supports comprehensive coordination of medical services including intake, screening and referrals. Promotes/supports quality effectiveness of Healthcare Services.
Fundamental Components:
Process intake of services via electronic fax system
issues auths in the system and faxes back auth numbers to the providers
Researches member eligibility information before creating auths
Authorizes services in accordance with SCHN.MCP
Documents all communication in the business application system
Maintains accurate and complete documentation required for regulatory accreditation.
Protects the confidentiality of member information and adheres to company policies.
Must possess strong customer service skills to coordinate services
Computer literacy a must to be able to navigate through internal and external systems
Familiar with basis medical terminology an d concepts of care management
Effective communication, telephonic and organizational skills
Proficient in keyboarding, typing min of 45 wpm with min score 6500 alphanumeric skill set.
BACKGROUND/EXPERIENCE desired:
2-4 years experience as a medical assistant, office assistant or other clinical experience. Call center experience/ heath insurance claims processing a plus.
EDUCATION
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
REQUIRED SKILLS
General Business/Communicating for Impact/ADVANCED
Service/Creating a Differentiated Service Experience/ADVANCED
Service/Handling Service Challenges/FOUNDATION
ADDITIONAL JOB INFORMATION
As an Inbound Queue Associate at American Health Holding Inc.- an Aetna company, you will be supporting comprehensive coordination of medical services including intake, screening and referrals to American Health Holdings Medical Service Programs. This includes promoting and supporting quality effectiveness of Healthcare Services.
We require:
• Call center experience strongly preferred
• Minimum of 2 years direct customer/patient contact required
• Experience with Medical Terminology, Billing/Coding, Healthcare strongly preferred
• Pre-certification experience extremely helpful
• Excellent computer skills with Windows experience
• Excellent verbal and written communication skills
• Detail oriented
• Must be a self-starter
• Must be able to work well independently as well as in a group setting
• Must be able to work holidays (pay would be adjusted for holiday hours)
Successful candidates MUST:
• Be flexible to work overtime
• Pass a mandatory drug screen
• Pass a comprehensive background check including verification of your employment and criminal record
• Be at least 18 years old
Shifts for this position will be 8 hours between 8:00am and 8:00pm, Monday through Friday. Schedules will rotate on a regular basis. You must be available to work any shift within these hours.
Training for this position will be Monday through Friday between 8:00am and 5pm for 4 weeks. You must attend every day of training with no absences. You'll have service expectations and goals and will be monitored for efficiency, accuracy and customer satisfaction.
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.
Job Function: Health Care