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Complaint &Appeal Clinical Analyst
- Work at Home Jobs, Work from Home Jobs
Posted: 2/2/2007
Location:
US-PA-King of Prussia
Base Pay:
N/A
Employee Type:
Full-Time Employee
Industry:
Healthcare - Health Services
Insurance
Manages Others:
No
Job Type:
Health Care
Professional Services
Req'd Education:
4 Year Degree
Req'd Experience:
At Least 3 Years
Req'd Travel:
Not Specified
Relocation Covered:
No
Contact Information
Contact: Not Available .
Phone: Not Available .
Email: Not Available .
Fax: Not Available
Ref ID: 27745002_33211243 .
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Complaint &Appeal Clinical Analyst
Company: Aetna
Learn more about this company >>
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Description
About Aetna
Aetna is one of the nation s leading diversified health care benefits companies, serving approximately 29.8 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, and long term care and disability, and medical management capabilities. Aetna provides benefits through employers in all 50 states, with products and services targeted specifically to small, mid-sized, and large multi-site national employers.
At Aetna, we value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna.
JOB RESPONSIBILITIES
This is your opportunity to join an exciting and growing unit as a Complaint &Appeal Clinical Analyst. As a Complaint &Appeal Clinical Analyst you will work within our team to coordinate effective resolution of member, provider/practitioner and facility clinical appeals and complaints.
As part of the Aetna Behavioral Health team you will utilize your strong clinical background, sound assessment and decision making skills, and creativity to apply and interpret appropriate clinical criteria and guidelines, policies, procedures and regulatory standards while assessing the member and/or provider/practitioner needs to ensure appropriate administration of benefit and/or facilitating optimal outcomes. Our Complaint &Appeal Clinical Analyst s are responsible for identifying and researching all components within member, provider/practitioner and facility clinical appeals. You will do this by creating accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements and will be able to involve the Medical Director as needed.
ADDITIONAL JOB INFORMATION
As an Aetna employee you will have access to the company's Intranet, a rich source of employee news and information. Aetna is a smoke-free work environment, and smoking is only permitted in designated areas outside each building. Aetna will provide you with resources to help balance work and life and a wide array of wellness services. Depending on location, job type and management team, even flexible work schedules are available.
This position is eligible for Work at home after 6 months of service based on performance.
How to apply
To learn more about this opportunity, visit us at www.aetna.com. Under requisition # select 14909 and submit your resume.
We conduct pre-employment drug and background testing.
No agencies, please.
Aetna is an equal opportunity/affirmative action employer.
Minimum of 5 years of behavioral health experience
3-5 years recent clinical experience
Ability to exercise independent and sound judgment in decision making, utilizing all relevant information to effectively facilitate the appeals process.
Strong verbal and written communication skills. Organizational skills, effective time management, ability to manage multiple priorities, and strong teamwork skills.
Candidate must possess strong computer and keyboarding skills.
Applicant Category: Professional
Requisition Code: Work at home
Two Initials of Recruiter: bw
System Date: 02/23/2007
System Time: 09:23:18
Document Name(40): Complaint &Appeal Clinical Analyst
Source: Philly.com
SearchTerms: "work at home" "work from home"
URL(80): http://www.careerbuilder.com/JobSeeker/Jobs/JobDetails.aspx?CiBookMark=1&dv=dv&s
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