Firm Name: Aetna

Numbers of Jobs: Claim Benefit Specialist

Education Need: Graduate

Job Hours: 8

Payment: $20-$30/Hours

What's Job City: Austin

Job Details:

The position description.

•  Regular claims that cannot be resolved automatically are examined and approved.
•  Medical necessity standards are used, coverage is established, eligibility is confirmed, discrepancies are discovered, and all cost-containment strategies are used to help with the claim adjudication process.
•  Organizes responses to common phone calls and written correspondence about problems with claim processing. routing and triaging complex claims before sending them to the senior claim benefits specialist.
•  the right standards, coding, member identification, provider selection, and claim coding, including the requirements for procedures, diagnoses, and precoding, are identified, reviewed, or applied. proofs of submission of a claim or referral.
•  It might assist with training, depending on the subject matter expert.
•  Manages claims on the desk, route/queues, and/or ECHS and/or ACCTS within the allotted turn-around-time limits and in accordance with the established operational guidelines.
•  ensures prompt and accurate claim processing by utilizing all pertinent system features (i. e. make use of post-containment tools like Claim Check, reasonable and customary data, etc.).

 The pay scale.

 The standard salary range for this position is:.

•  There is a minimum of 17.00.
•  The top value is 27.90.

 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade under which this position is classified. The actual base salary will be offered based on a number of factors, including experience, education, geography, and other relevant factors. This position is additionally qualified for a CVS Health bonus, commission, or short-term incentive program in addition to the aforementioned base pay range.

 In addition to your salary, take pleasure in the advantages of working for a company that cares deeply about its workers and the community. The company offers complete medical, dental, and vision benefits. All eligible employees are eligible to participate in the Company's 401(k) retirement savings plan and the Employee Stock Purchase Plan. The Company provides short- and long-term disability benefits, as well as a fully paid term life insurance plan, to qualified employees. CVS Health offers a wide range of additional services, including numerous wellness initiatives, educational support, free training courses, CVS store discounts, and partner discounts. All through the year, paid time off (PTO), vacation pay, and paid holidays are available to Company employees. In accordance with applicable state law and company policies, a large number of paid holidays, sick days, and other vacation days are provided.

 For comprehensive details on the benefits provided, please visit.

 jobs. gains at cvshealth.com.

 necessary credentials.

•  understanding the language of medicine.
•  exceptional written and verbal English communication abilities.
•  maintaining standards for accuracy and output.
•  able to switch between various systems.
•  focus on detail and accuracy.
•  analytical and critical thinking abilities.

 Recommendations for qualification.

•  insurance or medical training.

 Education.

•  comparable to a high school diploma or the GED.