Recovery/Savings Analyst

Job Status: Full TimeJob Category: Accounting/Finance/InsuranceEducation Level: High School or equivalentExperience Required: 2+ to 5 Years Email this Job to a Friend | See All Aetna Opportunities | Learn more about Aetna We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice is heard. Recovery/Savings Analyst Job Description Fast, accurate claims payment is one of the ways we make a difference in people's lives.  Claims professionals work directly with members, doctors and employer groups, providing a friendly and knowledgeable voice at the other end of the phone at times when it's most neededThe successful candidate will be a member of the Aetna Pharmacy Management (APM) Coordination of Benefits (COB) team. -Identify pharmacy claim expense dollars and aggressively pursuing recovery of overpaid dollars from liable parties -Review and research conflicting, missing or inaccurate COB information via telephone and/or written correspondence -determine benefit coverage including using Medicare or NAIC order of benefit guidelines  -Report inventory and recovery results, audit claim history and contact other insurance carriers, providers and members by phone -Maintain and utilize resource materials to manage job responsibilities and handle inquiries from internal and external constituent Required Skills: -Knowledge of Health Plan Benefits (especially Pharmacy, coordination of benefits and Medicare) are a must -Must possess demonstrated analytical skills; decision-making abilities; organization and planning skills; excellent verbal and written communication skills; and be detail oriented  -Must be able to work independently, pay close attention to detail and have excellent follow-through skills -Must have proven expertise with computer software for example, Microsoft products -Thorough understanding of Medicare Part D policies and reimbursement guidelines is highly desirable -Knowledge or experience with the APM system is preferred Training for this position is primarily through on-the-job training.