Support comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services. Performs intake of fax request from providers regarding services via telephone, fax or web-portal. Utilize QNXT, Profax, ProPat and other Aetna systems to build authorizations, research and enter member information. Screen requests for appropriate referral to medical services staff. Approve services that do not require medical review in accordance with the benefit plan. Performs non-medical research including eligibility verification, COB, and benefits verification.
2-4 years experience as medical assistant, office assistant or other clinical experience.
High School Diploma or GED.
Associate or Bachelor's Degree
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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