Req ID: 13783BR
Candidate must be located in commuting distance to an Aetna office, and is required to work in Pacific Time. There is the potential to work from home after proven performance.POSITION SUMMARY
Support comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.
As part of the West Region Patient Management team, your daily functions include: answering incoming calls from providers or members regarding precertification or registration for surgical procedures, coordinating care with appropriate nurses; verifying eligibility, referring/transferring callers to appropriate clinical staff; and providing excellent customer service. The job responsibilities require the ability to learn multiple processes and complete them consistently, efficiently and in compliance with detailed procedures.
EDUCATION
The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.REQUIRED FUNCTIONAL EXPERIENCESFunctional - Customer Service/call center environment/outgoing calls/1-3 Years
Functional - Customer Service/Provider/Member - HMO/1-3 Years
Functional - Customer Service/Medical Transcription/Medical Terminology/1-3 Years
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Outlook/1-3 Years
Technical - Desktop Tools/Microsoft Word/1-3 Years
Technical - Aetna Applications/Aetna Total clinical View/1-3 Years
Technical - Aetna Applications/TE eTUMS -Total Utilization Management System Internet/1-3 Years
REQUIRED SKILLS
Benefits Management/Interacting with Medical Professionals
Service/Handling Service Challenges
Technology/Leveraging Technology
DESIRED SKILLS
General Business/Maximizing Work Practices
Service/Demonstrating Service Discipline
Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Job Function: Health Care