Job Details

The Inbound/ Outbound Queue Associate is a fully telework position. The schedule is Wednesday through Sunday, 8 am-5 pm CST. Supports 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 calls from members or providers regarding services via telephone, fax, EDI. Utilizes e. MEVS and other Aetna systems to build, research and enter member information. Screens requests for appropriate referral to medical services staff. Approve services that do not require a medical review in accordance with the benefit plan. Performs non-medical research including eligibility verification, COB, and benefits verification. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Protects the confidentiality of member information and adheres to company policies regarding...Associate, Medical Director, High School, Retail