[New Job Opening] Nurses (Indian Registered & US Registered) CHENNAI job Vacancy in Chennai, Tamil Nadu

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Job Details:
Position Name :
Nurses (Indian Registered & US Registered) CHENNAI
Location:
Chennai, Tamil Nadu
Job ID :
24bffc41f0be828c
Description : Job Description
IRN:
Job Group Healthcare
Family Name Care Management
Fundamental Components and Physical Requirements (include but are not limited to)
Note: * denotes essential functions
Performs intake of calls from members or providers regarding services via telephone, fax, EDI (*)
Utilizes eTUMS and other Aetna system 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 that meets risk management, regulatory, and accreditation requirements (*)
Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g. Claim Administrators, Plan Sponsors, and 3rd party payers as well as Member, Family, and Healthcare Team Members respectively)
Protects confidentiality of member information and adheres to Aetna policies regarding confidentiality (*)
Communicate with Aetna Case Managers, when processing transactions for members active in this Program (*)
Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to Aetna policy and procedures (*)
Job Information
Salary
5,00,000 – 10,00,000 annual salary
Work Experience
1+ Years
City
Chennai
State/Province
Tamil Nadu
Country
India
Industry
IT Services
Zip/Postal Code
560002
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