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InbOutb Queue Assoc

Company: CVS Health
Location: Kenner
Posted on: June 8, 2021

Job Description:

Job Description

information and adheres to

company policies regarding confidentiality Communicate

with Aetna Case Managers, when processing transactions

for members active in this ProgramSupports the

administration of the precertification process in compliance

with various laws and regulations, URAQ and/or NCQA

standards, where applicable, while adhering to company

policy and procedures.Places outbound calls to providers

under the direction of Medical Management Nurses to

obtain clinical information for approval of medical

authorizations.Uses Aetna Systems such as QNXT,

ProFAX, ProPAT, and Milliman Criteria.Communicates with

Aetna Nurses and Medical Directors, when processing

transactions for members active in this Program. Sedentary work involving significant periods of sitting, talking, hearing

and keying.Work requires visual acuity to perform close

inspection of written and computer generated documents

as well as a PC monitor. Working environment includes

typical office conditions.

Required Qualifications

High School Diploma or GED

Preferred Qualifications

2-4 Years of Medical Assistant

Education

High School Diploma or GED

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.

Keywords: CVS Health, Kenner , InbOutb Queue Assoc, Other , Kenner, Louisiana

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