Aetna Remote Work From Home Jobs – CAB

Job Responsibilities: Appeals Nurse Consultant

Salary: $30-40/Hour

Company: Aetna

Location: South Dakota, USA

Educational Requirements: Associate Degree

Full Job Description:-

Position Summary

The Appeals Nurse Consultant role is chargeable for processing the scientific necessity of Medicare Part C appeals from each individuals and companies. This function is taken into consideration a manufacturing function and stays as a part of the Nurse Appeal Consultant activity code. Primary responsibilities may also include, however aren’t restrained to: soliciting for scientific, research, extrapolating pertinent scientific, making use of suitable Medicare Guidelines, navigate thru a couple of pc device packages in a quick paced branch. Must paintings independently in addition to in a crew surroundings whilst operating remotely. The Medicare Clinical Appeals Team C Member/Non-Par Team operates 7 days in step with week, one year in step with year. This role calls for a few weekends and vacations on a scheduled rotation. Aetna Remote Work From Home Jobs

Must be snug in a quick-paced surroundings
Ability to fulfill closing dates in a closing date in depth surroundings
High degree of adaptability and willingness to include extrade in a quick-paced, disturbing surroundings
Demonstrates a stable knowledge of all workflows, policies, and procedures
Must have capacity to apply arms for repetitive typing, enter data, copy, communicate clearly, view pc monitors
Responsible for reviewing & making ready appeals submitted through sufferers or healthcare companies for MD review
Collaborate with inner commercial enterprise companions and outside entities to acquire and compare vital records
Provide written pointers or selections primarily based totally on to be had scientific, making sure adherence to CVS Health and Medicare guidelines.
Attend and take part in branch meetings. Aetna Remote Work From Home Jobs
Meticulous interest to element with correct documentation
Prepare templates the usage of established decision-making frameworks extrapolating pertinent scientific records from affected person records
Proficiency with pc talents consisting of Microsoft Outlook, Windows, navigating a couple of structures and keyboarding
Time green and fantastically organized
Exceptional verbal and written communique talents
Highly conscious of element whilst taking initiative staying on pinnacle of quite a few duties simultaneously

Required Qualifications

Active and unrestricted RN licensure in nation of residence
3+ years of scientific experience
Preferred Qualifications
Utilization Review experience
Medicare experience, Aetna Remote Work From Home Jobs
Appeals experience

Education

Associate’s Degree or RN degree required

Pay Range

The traditional pay variety for this function is:

$61,360.00 – $132,600.00

This pay variety represents the bottom hourly price or base annual complete-time earnings for all positions withinside the activity grade inside which this role falls. The real base earnings provide will rely on a range of things consisting of experience, training, geography and different applicable factors. This role is eligible for a CVS Health bonus, fee or short-time period incentive software further to the bottom pay variety indexed above. Aetna Remote Work From Home Jobs

In addition on your compensation, revel in the rewards of an enterprise that places our coronary heart into worrying for our colleagues and our communities. The Company gives a complete variety of scientific, dental, and imaginative and prescient benefits. Eligible personnel may also join withinside the Company’s 401(k) retirement financial savings plan, and an Employee Stock Purchase Plan is likewise to be had for eligible personnel. The Company affords a fully-paid time period lifestyles coverage plan to eligible personnel, and short-time period and long time incapacity benefits. CVS Health additionally gives severa well being applications, training assistance, unfastened improvement courses, a CVS shop cut price, and cut price applications with collaborating companions. As for time without work, Company personnel revel in Paid Time Off (“PTO”) or holiday pay, in addition to paid vacations all through the calendar year. Number of paid vacations, unwell time and different time without work are furnished constant with applicable nation regulation and Company policies. Aetna Remote Work From Home Jobs

About Aetna

Aetna is an American-controlled healthcare agency that offers quite a few healthcare coverage merchandise and associated offerings. Aetna became a subsidiary of CVS Health Corporation and is certainly considered one of the most important pharmacy and healthcare businesses in the United States. Aetna became based in 1853 and has a protracted record inside the coverage industry. Over the years, it has developed and multiplied its offerings to end up an outstanding participant in the healthcare sector. Products and Services: Aetna gives an extensive variety of medical health insurance merchandise, which includes medical, dental, pharmacy, disability, and different associated offerings. The agency caters to individuals, employers, and authority entities. Aetna Remote Work From Home Jobs

While the specific rules and responsibilities of companies in the United States can vary depending on factors such as industry, size, and location, there are some common rules and responsibilities that many companies adhere to. Here are a few examples:

Compliance with labor laws: Companies in the United States are required to comply with various labor laws, such as the Fair Labor Standards Act (FLSA), which establishes minimum wage, overtime pay, and child labor standards. They must also adhere to laws related to workplace safety and health, including the Occupational Safety and Health Act (OSHA).
Equal employment opportunity: Companies are expected to provide equal employment opportunities to all individuals, regardless of their race, color, religion, sex, national origin, age, disability, or genetic information. This includes complying with laws such as Title VII of the Civil Rights Act of 1964 and the Americans with Disabilities Act (ADA).
Payroll and tax obligations: Companies are responsible for properly handling payroll, including calculating and withholding taxes from employees’ wages, and submitting the required tax payments to federal, state, and local tax authorities. They must also provide employees with necessary tax forms, such as W-2s.
Workplace safety and security: Companies must provide a safe and secure work environment for their employees. This includes implementing safety protocols, providing necessary safety training, maintaining equipment and facilities, and addressing potential hazards.
Non-discrimination and harassment policies: Many companies have policies in place to prevent discrimination and harassment in the workplace. These policies often include procedures for reporting and addressing complaints, as well as consequences for violators.
Privacy and data protection: Companies are expected to handle the personal and sensitive information of their employees and customers responsibly. This may involve implementing measures to protect data privacy, complying with applicable data protection laws, and informing individuals about the collection, use, and storage of their personal information.
Ethical conduct and corporate social responsibility: Companies are encouraged to conduct their business ethically and responsibly. This may include promoting fair trade practices, adhering to environmental regulations, supporting social causes, and practicing transparency in their operations.

Aetna Remote Work From Home Jobs – CAB