Inbound/Outbound Queue Associate

• Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs
• Performs intake of calls from members or providers regarding services via telephone, fax, EDI
• Utilizes eMEVS 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
• Protects the confidentiality of member information
• Supports the administration of the precertification process
• 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, FAXHUB, ProPAT, and MedCompass
• Communicates with Aetna Nurses and Medical Directors

• High School Diploma or G.E.D
• 2-4 years of medical assistant experience (preferred)

2-4 years of medical assistant experience

• Affordable medical plan options
• 401(k) plan with matching company contributions
• Employee stock purchase plan
• Wellness screenings
• Tobacco cessation programs
• Weight management programs
• Confidential counseling
• Financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access