Clinical Call Center

Job description:

• Managing incoming calls (high call flow environment)
• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests
• Refers cases requiring clinical review to a Nurse reviewer
• Responsible for the identification and data entry of referral requests into the UM system
• Responds to telephone and written inquiries from clients, providers and Aetna’s internal departments
• Checks benefits for facility-based treatment
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

We are currently recruiting a Clinical Call Center for our team in Danbury, CT, United States.

We aim to respond to suitable candidates as soon as possible.

Full responsibilities and requirements are described in the listing above.