Aetna Quality Analyst in Sandy, Utah
Req ID: 38892BR
Telework is open to current internal teleworkers only.
The focus of the National Advantage Reconciliation Team, (NAR) Team is to ensure the accuracy of customer and vendor fees generated as a result of discounts and reductions under the National Advantage and Itemized Bill Review programs. The success of the National Advantage Reconciliation Team, (NAR) Team translates into improved earnings for Aetna.
Fundamental Components includes, but is not limited to:
The National Advantage Reconciliation (NAR) Team conducts claim quality audits to evaluate claim handling and accuracy of discounts and reductions in conjunction with the National Advantage and Itemized Bill Review Programs. Review includes confirming accuracy of vendor fees paid and plan sponsor fees charged. Must consistently maintain quality and production standards set for NAR Quality Analysts. Must be flexible to perform special quality audits and participate in quality initiatives as requested.
1-3 yrs. processing experience handling hospital, physician & other medical claim types on the ACAS platform; Required
Must have a working understanding of all traditional products; Required
Must have strong analytical, organizational, time management &computer skills.
In good standing with department attendance policies; Required
The minimum level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
For external applicants, you must be commutable and comfortable working in one of the following Aetna office locations: Fresno CA, Jacksonville FL, High Point NC,Bismarck ND, Albany NY, New Albany OH, Arlington TX, Cranberry PA, Harrisburg PA, Moon Township PA, San Antonio TX, Sandy UT, and Scottsdale AZ . For internal Aetna employees, you must be comfortable working in the above locations, and the team is also able to consider employees commutable to Allentown, PA.
Functional - Claims/Claim processing - Medical or Hospital - ACAS/1-3 Years
Functional - Quality Management/Quality Management/1-3 Years
Technical - Aetna Applications//1-3 Years/
Technical - Desktop Tools//1-3 Years/
Office based or full time telework. Telework is limited to existing internal teleworkers only, there is no opportunity for new telework arrangement.
ADDITIONAL JOB INFORMATION
Internal candidates with strong ACAS medical claim background will be considered for this position. Telework will be considered only as per existing arrangements, no new opportunity. This position may also require overtime based on business needs.
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.
Job Function: Quality Management