Claim Benefit Specialist-
Are you a compassionate and detail-oriented individual with a passion for helping others? Aetna is seeking a skilled and dedicated Claim Benefit Specialist to join our team. As a Claim Benefit Specialist, you will play a crucial role in ensuring our customers receive accurate and timely reimbursement for their medical claims. Your strong communication skills and ability to navigate complex insurance policies will be essential in this role. If you are looking for a rewarding career that makes a positive impact on people's lives, we encourage you to apply for this position. Review and process medical claims in accordance with company policies and procedures. Communicate with healthcare providers, insurance brokers, and customers to gather necessary information and resolve claim issues. Verify claim eligibility and benefits, including coverage limits and exclusions. Analyze and interpret complex insurance policies to determine claim validity. Ensure accurate and timely reimbursement for medical claims. Maintain a high level of accuracy and attention to detail when processing claims. Provide exceptional customer service to address any questions or concerns related to claims. Collaborate with cross-functional teams to identify areas for process improvement and implement solutions. Comply with all regulatory requirements and company guidelines. Keep up-to-date on industry changes and trends related to claim processing and insurance policies. Maintain confidentiality of sensitive customer and company information. Meet or exceed performance metrics and quality standards. Participate in training and development opportunities to enhance skills and knowledge. Adhere to company values and ethics in all interactions with customers and colleagues. Communicate effectively and professionally with team members and other departments. Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.