As a Work-from-Home Claims Processor at Aetna, you will play a crucial role in ensuring timely and accurate processing of insurance claims. This position requires a keen eye for detail, analytical skills, and the ability to navigate complex data. You will review claims submissions to verify accuracy, investigate discrepancies, and ensure compliance with company policies and regulatory requirements. Your role will involve collaborating with various departments to resolve claims issues and support our commitment to excellent customer service. With a focus on efficiency and accuracy, you will help maintain the integrity of our claims processing system while working independently in a remote environment. Aetna offers a supportive culture that emphasizes professional growth and development, providing the tools and resources needed to succeed in this essential role.

Key Responsibilities:

• Review and process insurance claims efficiently and accurately, adhering to company guidelines and standards.
• Investigate claims discrepancies and gather necessary information to resolve issues.
• Communicate with healthcare providers, policyholders, and internal teams to clarify information and address concerns.
• Maintain accurate records of claims processing activities in our database systems.
• Ensure compliance with all relevant regulations and policies throughout the claims process.
• Assist in identifying areas for process improvement and contribute to team initiatives aimed at enhancing operational efficiency.
• Provide excellent customer service by addressing inquiries and resolving issues promptly.

Required Skills and Qualifications:

• High school diploma or equivalent; associate or bachelor degree preferred.
• Strong attention to detail and analytical thinking skills.
• Proficient in data entry and comfortable working with various software systems.
• Excellent verbal and written communication skills.
• Ability to manage time effectively and work independently with minimal supervision.
• Familiarity with insurance claims processing is an advantage.

Experience:

• Previous experience in a claims processing role or a similar position is preferred.
• Experience in the healthcare or insurance industry is a plus.

Working Hours:

• Full-time position with flexible scheduling options.
• Ability to work standard business hours with some potential for overtime during peak periods.

Knowledge, Skills, and Abilities:

• Strong organizational skills with the ability to prioritize tasks effectively.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and claims processing software.
• Understanding of healthcare insurance policies and regulations is beneficial.
• Ability to work effectively in a remote environment, utilizing communication tools and technology.

Benefits:

• Competitive salary and performance-based bonuses.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company match.
• Paid time off and holidays.
• Opportunities for professional development and advancement.

Why Join Aetna?
At Aetna, we believe in fostering a diverse and inclusive work environment where employees can thrive. Joining our team means being part of a company that values innovation, collaboration, and integrity. We are dedicated to providing exceptional care to our members and supporting our employees in achieving their professional goals. As a Work-from-Home Claims Processor, you will have the flexibility to work from home while contributing to meaningful work that impacts lives.

How to Apply:
Interested candidates are encouraged to submit their resume and a cover letter outlining their relevant experience and qualifications. Applications can be submitted through our careers page at Aetna Careers. We look forward to hearing from you!