Coordinator – Special Investigations Unit – Aetna SIU
| Company | CVS Health |
|---|---|
| Location | New Mexico, USA, Washington, USA, Kansas, USA, Pennsylvania, USA, North Dakota, USA, Oregon, USA, Delaware, USA, Iowa, USA, California, USA, Washington, DC, USA, Vermont, USA, Wyoming, USA, Texas, USA, Montana, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, Nevada, USA, South Carolina, USA, South Dakota, USA, Georgia, USA, Arizona, USA, Concord, NH, USA, Mississippi, USA, Tennessee, USA, Virginia, USA, Arkansas, USA, Minnesota, USA, Colorado, USA, Nebraska, USA, Rhode Island, USA, Utah, USA, Kentucky, USA, West Virginia, USA, New York, NY, USA, Maryland, USA, Wisconsin, USA, Maine, USA, Massachusetts, USA, North Carolina, USA, Oklahoma, USA, Missouri, USA, Ohio, USA, Indiana, USA, Louisiana, USA, Michigan, USA, Illinois, USA, Alabama, USA, Idaho, USA |
| Salary | $18.5 – $42.35 |
| Type | Full-Time |
| Degrees | |
| Experience Level | Junior |
Requirements
- 1+ years claim processing and/or customer service experience and/or prior Medical Claim Analyst experience.
- 1+ years of SIU Analyst experience or demonstrated ability to handle multiple assignments competently, accurately, and efficiently.
- Experience HRP, GPS, and EPDB.
- Experience working in Microsoft Excel.
Responsibilities
- Runs initial Case Set Up reports, and gathers additional information relevant to the case.
- Documents the receipt of new incoming referrals/leads for tracking purposes and prepares referrals for transfer to either Level 2 Triage or to Investigative Teams.
- Maintains clear, concise, accurate, and complete documentation in the case tracking application.
- Efficiently utilizes available resources and technology while performing the referral triage function.
Preferred Qualifications
- Strong analytical and research skills.
- Independent worker who is proficient in researching information and utilizing all available resources.
- Self-managed decision-maker, who looks beyond the immediate problem for root cause.
- Clear verbal and written communication skills.
- Strong customer service skills.
- Ability to interact with various business partners and offer assistance on a timely basis.
- Proficient in Microsoft Word and Outlook and in the use of the Intranet/Internet to research information.
- Ability to utilize company systems to obtain relevant electronic documentation.
- Knowledge of Aetna’s policies and procedures.