Are you a detail-oriented and analytical individual with a passion for healthcare? Do you have a strong background in medical services claims, guarantee handling, and guarantee stages? If so, we invite you to join our team at arenaflex as an Experienced Claims Analyst – Waste & Abuse Ideator.
**About arenaflex**
arenaflex is a leading healthcare company dedicated to delivering innovative solutions that improve patient outcomes and reduce healthcare costs. Our mission is to carry our heart to every moment of your wellbeing, and we're committed to making a positive impact on the lives of our patients, customers, and employees.
**Our Heart At Work Behaviors**
At arenaflex, we believe that our employees are the heart of our organization. That's why we've developed our Heart At Work Behaviors, which are designed to support our mission and values. These behaviors include:
* **Carry Your Heart**: We're passionate about making a difference in the lives of our patients and customers.
* **Be the Change**: We're committed to driving innovation and improving patient outcomes.
* **Act with Heart**: We treat each other with kindness, respect, and empathy.
* **Be Accountable**: We take ownership of our actions and decisions.
* **Be a Lifelong Learner**: We're committed to continuous learning and professional development.
**Job Summary**
As an Experienced Claims Analyst – Waste & Abuse Ideator, you'll play a critical role in supporting our Waste and Misuse program within Investigation and Conduct Change. You'll be responsible for managing a variety of regulatory and project management tasks, including daily oversight and management of clinical records stock, ongoing monitoring and answering system post box sections, and updating project documentation as needed. You'll also identify and investigate program-specific issues, develop solutions, and lead the resolution of issues with internal colleagues, external vendors, and suppliers.
**Key Responsibilities**
* Identify key business drivers for your area of responsibility.
* Develop and maintain effective relationships with internal and external partners.
* Communicate clearly and effectively with stakeholders, including program administrators, choice researchers, and other partners.
* Develop and implement solutions to program-specific issues.
* Manage and maintain accurate and up-to-date clinical records stock.
* Monitor and respond to system post box sections.
* Update project documentation as needed.
* Collaborate with program administrators and other partners to achieve functional and financial targets.
* Work effectively independently and as part of a team.
**Essential Qualifications**
* 3-5 years of industry experience in medical services claims, guarantee handling, and guarantee stages.
* 3+ years of experience in claims handling information and experience within ACAS, QNXT, or HRP (HRP is highly preferred).
* Proficiency in QuickBase.
* Ability to work independently and as part of a team.
* Strong analytical and research skills.
* Ability to explore data and identify data assets.
* High level of conscientiousness.
* Strong verbal and written communication skills.
**Preferred Qualifications**
* Ability to interact with various groups at various levels.
* Ability to use organization systems to obtain pertinent electronic documentation.
* Knowledge of Aetna's strategies and techniques.
* Demonstrated written and verbal communication skills with the ability to present information to diverse audiences.
* Proficiency in Word, Excel, database search tools, and the use of the Intranet/Web to explore data.
**Training and Development**
* A bachelor's degree or three years of equivalent experience in the healthcare industry is preferred.
**Compensation and Benefits**
* The base salary range for this position is $70,000 - $80,000 per year.
* arenaflex offers a comprehensive benefits package, including medical, dental, and vision benefits, as well as a 401(k) retirement savings plan and a stock purchase plan.
* arenaflex is committed to providing a safe and healthy work environment, and we offer a range of wellness programs and resources to support our employees' physical and mental health.
* arenaflex is an equal opportunity employer and welcomes applications from diverse candidates.
**How to Apply**
If you're a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply now! Please submit your application, including your resume and a cover letter, through our online portal. We can't wait to review your application and discuss this exciting opportunity with you.