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Sr Claim Benefit Specialist- Ops

Company: Aetna Inc.
Location: Dover
Posted on: September 24, 2022

Job Description:

Job Description

* Works to research and resolve encounter errors
* Reviews and adjust complex, sensitive, and/or specialized claims in accordance with claim processing guidelines.
* Ensures all compliance requirements are satisfied and that all payments are made against company practices and procedures
* Identifies and reports possible claim over payments, underpayments and any other irregularities

Pay Range

The typical pay range for this role is:

Minimum: 18.50

Maximum: 33.65

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

* 2+ years claim processing experience
* Ability to research complex issues
* Demonstrated ability to handle multiple assignments competently, accurately and efficiently.

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications

* QNXT experience is highly desired.

Education

Associates degree or equivalent experience.

Business Overview

Bring your heart to CVS Health

Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors--- support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day.

CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Keywords: Aetna Inc., Wilmington , Sr Claim Benefit Specialist- Ops, Other , Dover, Delaware

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