Job Responsabilités Perform capacity planning and reporting. Claims related and business system analysis Responsible for all aspects of quality assurance. Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions Auditing the claims done by Claim associates. Manual Claim Adjudication for multiple health care specialties, places of service, benefits and plan types

Job Responsabilités Perform capacity planning and reporting. Claims related and business system analysis Responsible for all aspects of quality assurance. Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions Auditing the claims done by Claim associates. Manual Claim Adjudication for multiple health care specialties, places of service, benefits and plan types. Knowledge of making daily reports and experience on MS-Excel, In-depth knowledge of the process and standards of business operation Excellent organizational and time management skills Ability to interact effectively with colleagues and customers Quick problem solver with ability to meet deadlines within limited time period Strong leadership with strong supervisory skills Knowledge about medical claims procedures and documents. Also, throughout knowledge of claim adjudication, medical billing procedures, insurance claims etc. with good communication skills both verbal and written. Exceptionally organized with a track record that demonstrates creativity and initiatives to achieve set goals Hardworking, motivated, energetic, dedicated, and professional individual able to serve clients in a conscientious and pleasant manner Strong ability to gather data, compiles information, and prepares reports. A proactive learner with a flair for adopting emerging trends & addressing industry requirements to achieve organizational objectives & profitability norms. Holds exceptional team spirit thereby helping in easy achievement of organizational& personal goals. An effective communicator with excellent relationship building & interpersonal skills.

Back office Sr. claim Associate Process- Aetna (Health Insurance Claims)