Lowongan Kerja Claim Benefit Specialist DKI Jakarta February 2017 InterGlobal Ltd (Singapore Branch)


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Here at Aetna, we are building a healthier world by making health care easy, affordable and all about you. Follow our LinkedIn page for company news, industry commentary, jobs, and more.

Founded in 1853 in Hartford, CT, Aetna is one of the nation's leading diversified health care benefits companies, serving an estimated 46.7 million people with information and resources to help them make better decisions about their health care.

Our Values:
At Aetna, we put people at the center of everything we do, making decisions based on integrity, caring, excellence and inspiration. “Our core values guide us to make a difference in your world and throughout the world we reach. I couldn’t be any more proud of the work our people do. Investing in our employees and their success is a cornerstone for building a healthier world.” -- Mark T. Bertolini, CEO and Chairman of Aetna.

Corporate Responsibility:
As a health care leader, we believe that our corporate responsibility starts with helping people live healthier lives. And that means using our resources to make the communities and world we live in better places. We firmly believe we can do well by doing good, and we continue to find new ways to broaden our impact, including through a strong social compact with our employees.

Diversity & Inclusion:
Our focus on diversity and inclusion reflects the world around us. Having a diverse group of employees gives us a broader and deeper view of how to serve the people and businesses in our communities.

Work with us:
Join us as we transform the health care system. Our employees are the cornerstone of our mission to help people live healthier lives. Get to know us, why we're passionate about what we do and what makes Aetna a great place to work. Check out our current job listings on the Careers tab.

Visit us at: https://www.aetna.com/


Claim Benefit Specialist


  • Analyzes and approves claims.
  • Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies all cost containment measures to assist in the claim adjudication process.
  • Coordinates responses for phone inquiries and written correspondence related to claim processing issues
  • Routes and triages High claims and seeks support and advice from designated Specialists. (Senior Claim Benefits Specialist).
  • Proofs claim or referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis and pre-coding requirements.
  • Investigate claims for possible abuse and fraud.
  • May facilitate training when considered topic subject matter expert.
  • In accordance with prescribed operational guidelines, manages claims on desk, route/queues, and all systems within specified turn-around-time parameters.
  • Utilizes all applicable system functions available ensuring accurate and timely claim processing service (i.e., use of all documented resources)
  • Escalate unresolved claims complaints and high costs claims to the claims supervisor for guidance
  • Continually work to improve best practices procedures and standards.
  • Ensures compliance with requirements of regional compliance authority/industry regulator.
  • Adheres to international privacy policies, practices and procedures.


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Cari Lowongan kerja Berdasarkan PROFESI KLIK DISINI

Jika Anda berminat mendaftar Lowongan Kerja Claim Benefit Specialist DKI Jakarta InterGlobal Ltd (Singapore Branch) pada tanggal 07-Jan-17 segera siapkan persyaratan/berkas dan dokumen yang dibutuhkan untuk mendaftar. Silakan klik tombol "Kirim Lamaran" di bawah ini. Jika belum menemukan lowongan kerja yang anda cari, silahkan ketik lowongan kerja dikotak pencarian dibawah ini dan baca juga lowongan kerja yang lainnya.


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