Experienced Aetna Finance Operations Specialist – Remote Opportunity with Competitive Salary and Benefits

Introduction to CVS Health and Our Mission

At CVS Health, we are driven by a singular, clear purpose: to bring our heart to every moment of your health. This purpose guides our commitment to delivering human-centered healthcare in a rapidly changing world. Anchored in our brand — with heart at its center — our mission sends a personal message that how we deliver our services is just as important as what we deliver. We believe that by putting our heart into our work, we can make a meaningful difference in the lives of our patients, customers, and communities.

Our Heart At Work Behaviors

Our Heart At Work Behaviors support our mission and are the foundation of our culture. We want every individual who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to grow and deliver solutions that make healthcare more personal, convenient, and affordable. We are committed to creating a work environment that is inclusive, supportive, and respectful of all employees, and we strive to make a positive impact on the communities we serve.

Job Overview

We are seeking an experienced Aetna Finance Operations Specialist to join our team. As a remote employee, you will have the opportunity to work from the comfort of your own home and enjoy a flexible schedule. Our ideal candidate will have excellent communication and organizational skills, with the ability to work effectively in a fast-paced environment. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity.

Key Responsibilities

• Conduct initial review and analysis of cases assigned for review
• Determine coverage, verify eligibility, identify and redirect errors
• Process approvals in the system and escalate cases to clinical staff for review
• Coordinate and prioritize work to meet regulatory and turnaround time requirements
• Facilitate communication, both internally and externally, to enhance the effectiveness of clinical management services and healthcare team
• Perform non-clinical research and support
• Maintain accurate and complete documentation of required data that meets risk management, regulatory, and authorization requirements
• Safeguard the confidentiality of member data and adhere to company policies regarding confidentiality
• Aid in the research and resolution of cases payment

Essential Qualifications

To be successful in this role, you will need to possess the following essential qualifications:

• Effective communication, telephonic, and interpersonal skills
• Knowledge of basic medical terminology and concepts used in care management
• Strong customer service skills to deliver service excellence, including attention to customers, prevention of issues, proactive identification, and resolution of issues to promote positive outcomes for members
• Computer proficiency to navigate through internal/external computer systems, including Excel and Microsoft Word
• Ability to effectively participate in a multi-disciplinary team, including internal and external stakeholders

Preferred Qualifications

While not required, the following preferred qualifications will be considered an asset:

• 2-4 years of experience as a clinical assistant, office assistant, or claims processor
• ATV, ASD, Med Compass

Career Growth Opportunities and Learning Benefits

At CVS Health, we are committed to helping our employees grow and develop in their careers. We offer a range of training and development programs, including online courses, workshops, and conferences, to help you build your skills and knowledge. Our employees also have access to a range of career advancement opportunities, including promotions, lateral moves, and career transitions. We believe that by investing in our employees, we can help them achieve their full potential and make a meaningful contribution to our organization.

Work Environment and Company Culture

Our company culture is built on a foundation of respect, inclusivity, and empathy. We believe that by creating a positive and supportive work environment, we can help our employees thrive and achieve their full potential. Our employees are passionate about delivering exceptional customer service and making a positive impact on the communities we serve. We are committed to creating a workplace that is inclusive, supportive, and respectful of all employees, and we strive to make a positive impact on the communities we serve.

Compensation, Perks, and Benefits

We offer a competitive salary and benefits package, including medical, dental, and vision benefits, a 401(k) retirement savings plan, and an employee stock purchase plan. Our employees also enjoy a range of perks, including paid time off, holidays, and discounts on CVS products and services. We believe that by offering a comprehensive compensation and benefits package, we can help our employees achieve a better work-life balance and improve their overall well-being.

Conclusion

If you are a motivated and detail-oriented individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity. As an Aetna Finance Operations Specialist, you will have the opportunity to work remotely and enjoy a flexible schedule, while also making a meaningful contribution to our organization. Don't hesitate to apply – we can't wait to hear from you!

Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today and take the first step towards an exciting and rewarding career with CVS Health!