As a Claim Benefit Specialist at Aetna, a CVS Health Company, I have over four years of experience in analyzing and approving routine claims that cannot be auto adjudicated. I apply guidelines, resolve eligibility issues, and identify and resolve discrepancies to complete the claim adjudication process, processing patient claims with accuracy and efficiency.I also have skills in auditing claims, verifying eligibility, following medical necessity guidelines, and ensuring cost measures for claim adjudication and adjustment. I utilize all applicable system functions and tools to ensure timely and quality service. I have a strong sense of urgency, goal orientation, and attention to detail. I am able to work independently and in a team environment, and I am motivated by the mission of providing security, safety, and well-being to all personnel, visitors, and premises.
Listed skills include Microsoft Office, Analysis, Customer Service, Liability, and 29 others.