Job Description
Job Description
This position is permanent work from home in any state.
* Processes and coordinates all plan benefit changes and required structural and administrative updates into systems essential for on-line viewing, claim enrollment and billing purposes.
* Analyzes and determines if products and services selected by customers are aligned with their benefit needs, and can be adequately supported by existing systems or operating platforms; additionally, seeks solutions and negotiates essential requirements in support of any non-standard plan selections.
* Consults and communicates with internal constituents regarding the details associated with new business and revision activity in a timely manner and validates account structure.
* Completes timely and accurate set-up of complex account structure and detailed benefit plans in systems for multiple constituents in order to satisfy both internal and external deadlines for production - impacting a wide variety products and services; May perform additional plan sponsor administration functions.
* Reviews benefit provisions to ensure compliance with state and Federal legislative mandates; evaluation process may also include assessment of summary plan descriptions and other related documents prepared by the plan sponsor or third party.
* If required, communicates revisions essential for supporting and guarding the plan against any unintended liability.
* Monitors and manages internal installation process and maintains case tracking tools to meet constituents expectations and business goals.
* Prepares complex employer contracts, custom contracts and/or employee custom certificates of coverage.
* Completes required data input into performance measurement systems in support of key business and management initiatives.
Required Qualifications
* Strong Microsoft Excel experience.
* Strong team player.
* Superior customer service skills.
* Ability to manage multiple priorities.
* Excellent verbal and written communication skills.
* Problem solving skills.
* Attention to detail and accuracy.
* Analytical skills.
Preferred Qualifications
Please see above.
Education
Bachelors Degree or High School Diploma with Equivalent work experience.
Business Overview
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.
This position is permanent work from home in any state.
* Processes and coordinates all plan benefit changes and required structural and administrative updates into systems essential for on-line viewing, claim enrollment and billing purposes.
* Analyzes and determines if products and services selected by customers are aligned with their benefit needs, and can be adequately supported by existing systems or operating platforms; additionally, seeks solutions and negotiates essential requirements in support of any non-standard plan selections.
* Consults and communicates with internal constituents regarding the details associated with new business and revision activity in a timely manner and validates account structure.
* Completes timely and accurate set-up of complex account structure and detailed benefit plans in systems for multiple constituents in order to satisfy both internal and external deadlines for production - impacting a wide variety products and services; May perform additional plan sponsor administration functions.
* Reviews benefit provisions to ensure compliance with state and Federal legislative mandates; evaluation process may also include assessment of summary plan descriptions and other related documents prepared by the plan sponsor or third party.
* If required, communicates revisions essential for supporting and guarding the plan against any unintended liability.
* Monitors and manages internal installation process and maintains case tracking tools to meet constituents expectations and business goals.
* Prepares complex employer contracts, custom contracts and/or employee custom certificates of coverage.
* Completes required data input into performance measurement systems in support of key business and management initiatives.
Required Qualifications
* Strong Microsoft Excel experience.
* Strong team player.
* Superior customer service skills.
* Ability to manage multiple priorities.
* Excellent verbal and written communication skills.
* Problem solving skills.
* Attention to detail and accuracy.
* Analytical skills.
Preferred Qualifications
Please see above.
Education
Bachelors Degree or High School Diploma with Equivalent work experience.
Business Overview
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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