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Job Title: Provider Data Srvc Sr. Analyst
Job Location: PA: Blue Bell
Pay Rate: Open
Job Length: full time
Start Date: 2008-03-15

Company Name: Aetna
Contact: HR
Phone: email only please
Fax: email only please

Description: Provider Data Srvc Sr. Analyst Job Group: Health Care Requisition #: 22684 Location: Blue Bell, PA Travel: 0 - 10%% FLSA Status: Non-Exempt Full/Part Time: Full Time Supervisory: No Compensation Pay Opportunity: $30,000.00 - $40,000.00 Bonus Potential: Variable %%

Requirements ABOUT OUR COMPANY We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. JOB MISSION SUMMARY The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge. RESPONSIBILITIES -Review new and existing demographic and contract reimbursement arrangements and determine most appropriate system entry methodology to facilitate accurate and consistent claim adjudication. -Provide ongoing business and technical direction relative to provider data structure set-ups in support of claims processing, enrollment/eligibility data, directories, DocFind and physician supplements. -Establish, maintain, and align provider demographic and negotiated reimbursement data across Aetna s provider applications - Enterprise Provider Data Base (EPDB), MainFrame Provider (HMO), and Strategic Contract Manager (SCM) for all products HMO/QPOS; Managed Choice; Elect Choice and PPO and Capitation arrangements. -Assesses all requests for complete and accurate information. -Completes contractually sensitive and complex provider data transactions, and directly contacts providers and/or outside vendors to clarify data quality issues. -Perform intake triage from various work sources (markets, providers, provider call centers, claims, provider solution teams) and respond to network inquiries including: provider requests (e.g., policy & procedures, credentialing status, claims status, provider loads, etc.) REQUIRED SKILLS -The ability to understand and use appropriate hardware/software and other technology necessary to research and enter information from a variety of incoming documents and sources into a Mainframe/PC database. -Accurate data analysis/entry skills. -Must have effective communication skills, both verbal and written, for handling internal and external customer calls and inquiries. -Must have demonstrated abilities to handle multiple assignments. -Excellent desktop management skills. -Demonstrated analytical skills required for interpreting provider demographics and contracts, assessing administrative and constituent impact, and interpreting/translating into meaningful information to assess business solution. -Must be a self motivated strong team player with the ability to prioritize workloads and meet deadlines with minimal supervision. -Project management skills. -Familiarity with provider database systems, claims, and managed care terminology is a plus. -High School Diploma/GED required. -1-3 years experience in Healthcare related field preferred. ADDITIONAL INFORMATION This position is located in Blue Bell, PA We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company. Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.

Please refer to Job code aetna-22684 when responding to this ad.

For FASTEST PROCESSING of your resume, please visit http://www.jobcircle.com/classifieds/1216247.html?source=ng to apply online.

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