EDI Eligibility Consultant - Work From Home
Posted on: 8 Mar 2021
Blue Bell, PA
Job Description
Job Description
This position is permanent work from home.
Coordinates electronic transfer of eligibility data and maintain enrollment databases.
Map files and data specifications based the customer's product and plan selection.
Customer facing interactions with clients and vendors demanding high levels of responsiveness.
Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns.
In addition, provide support for ID cards.
Required Qualifications
Prioritization and organization skills must be strong in order to manage assigned case load and meet responsiveness expectations.
Professionalism to interact with clients, vendors and business partners as a representative of the Electronic Enrollment Department.
Responsiveness to inquiries within established service level agreements.
Demonstrated technical and analytical skills.
Preferred Qualifications
Please note that an individual with EDI (electronic eligibility file handling) is a plus.
Excel and Word experience required
Database (e.g., Quickbase) experience a plus
Salesforce experience
Excellent analytical skills
The ability to prioritize multiple urgent tasks; strong time-management skills
Able to work well with all types of people
Information management, data management, programming and documentation skills
Successfully work in a fast paced environment.
Excellent verbal and written communication skills
Education
High School Diploma or GED equivalent required
Associates degree+ preferred
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Aetna
Hartford, CT
Aetna Inc. operates as a health care benefits company in the United States. It operates through three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment offers medical, pharmacy benefit management service, dental, behavioral health, and vision plans on an insured and employer-funded basis. It also provides point-of-service, preferred provider organization, health maintenance organization, and indemnity benefit plans, as well as health savings accounts and consumer-directed health plans.
In addition, this segment offers Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers’ compensation administrative services, and products that provide access to its provider networks in select geographies. The Group Insurance segment offers life insurance products, including group term life insurance, voluntary spouse and dependent term life insurance, group universal life insurance, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which provide the benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities.
The Large Case Pensions segment manages various retirement products comprising pension and annuity products primarily for tax-qualified pension plans. The company provides its products and services to employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is based in Hartford, Connecticut. As of November 28, 2018, Aetna Inc. operates as a subsidiary of CVS Pharmacy, Inc.
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IndustryInsurance
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No. of Employees47,950
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Website
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Jobs Posted12677
