Aetna Senior Quality Analyst in Evansville, Indiana

Req ID: 54803BR

POSITION SUMMARY

The Senior Quality Analyst position verifies the accuracy of the claims system to ensure a quality customer experience. Through review of plan document language and claim testing, the Senior Quality Analyst confirms the claims system agrees to supporting documentation.

Fundamental Components:

  • Verify the claims system aligns with plan document language

  • Participate in client/broker implementation meetings, as necessary

  • Document audit findings

  • Share audit results with key business partners

  • Validate system discrepancies are resolved

    BACKGROUND/EXPERIENCE desired:

  • Healthcare industry experience (e.g. customer service, claims, appeals, etc.)

  • Excel skills at the basic level

  • Strong attention to detail

  • Excellent written and verbal communication skills

    EDUCATION

    The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

    Telework Specifications:

    Preferred office locations include Plymouth, MN and Amherst, NY

    ADDITIONAL JOB INFORMATION

    Meritain Health is a Third Party Administrator (TPA), providing plan administration for self-funded and fully insured clients. The Senior Quality Analyst position has the opportunity to positively impact both internal and external customers. It is a great role to learn more about the client experience and what it means to be a TPA.

    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.

    Aetna takes our candidates'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.

Job Function: Quality Management

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.