**Experienced Claims Analyst – Waste & Abuse Ideator at arenaflex**

Join arenaflex, a leading healthcare company dedicated to delivering innovative solutions that transform the way we approach healthcare, as an Experienced Claims Analyst – Waste & Abuse Ideator. This exciting opportunity is part of our Investigation and Conduct Change team, where you will play a vital role in supporting our Waste and Misuse program. At arenaflex, we believe that our employees are the heart of our organization, and we strive to create a work environment that is inclusive, supportive, and empowering. Our Heart At Work Behaviors support our mission to deliver human-driven healthcare that makes a meaningful difference in people's lives. As a member of our team, you will have the opportunity to work collaboratively with colleagues, contribute to the development of innovative solutions, and make a positive impact on the lives of our patients and customers. **About arenaflex** arenaflex is a healthcare company that is committed to delivering high-quality, patient-centered care. Our mission is to carry our heart to every moment of your wellbeing, and we strive to achieve this through our dedication to innovation, quality, and compassion. With a strong focus on employee development and well-being, we offer a range of benefits and opportunities for growth and advancement. **Job Summary** As an Experienced Claims Analyst – Waste & Abuse Ideator, you will be responsible for supporting the Waste and Misuse program within Investigation and Conduct Change. This role will involve managing a variety of administrative and project management tasks, including daily oversight and management of clinical records inventory, ongoing monitoring and answering system post box sections, and updating project documentation as needed. You will identify and investigate program-specific issues, develop solutions, and lead the resolution of issues in collaboration with internal colleagues, external vendors, and suppliers. **Key Responsibilities** * Identify key business drivers for own area of responsibility * Ability to communicate effectively with internal and external partners * Clarify item vision and methodology for partners within A&BC, recognizing fully how the item aligns with CVSH * Identify suitable data sources for examination solutions * Conduct daily monitoring of clinical record inventory to selection result * Work directly with key junior partners * Ability to analyze an issue or complaint, develop a solution, and implement a response * Ability to work autonomously and make independent decisions * Assist with support of overall program documentation * Drive engagement with colleagues * Ability to seek solutions to issues by collaborating with others * Will work with Program Manager to plan and prioritize * Develop cycles of assessing prioritization of issues and goals * Write clear, concise communication that accurately reflects the information with direction **Essential Qualifications** * 3-5 years of industry experience in medical services claims, guarantee handling, and guarantee stages * 3+ years in claims handling experience and knowledge within ACAS, QNXT or HRP (HRP strongly preferred) * Proficient in QuickBase * Ability to work autonomously * Strong analytical and research skills * Ability to explore data and identify data assets * Conscientious * Strong verbal and written communication skills **Preferred Qualifications** * Ability to interact with various groups at various levels * Ability to use organization systems to obtain relevant 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, Data search tools, and the use of the Intranet/Web to explore data **Training** * Preferred Four-year degree or three years of equivalent experience in the healthcare industry **Compensation and Benefits** * The base compensation range for this role is $70-$80 per year * arenaflex offers a range of benefits, including: + Comprehensive medical, dental, and vision benefits + 401(k) retirement savings plan + Employee Stock Purchase Plan + Paid time off and holidays + Education assistance and professional development opportunities + Access to a range of employee discounts and perks **How to Apply** If you are a motivated and detail-oriented individual with a passion for healthcare and a commitment to excellence, we encourage you to apply for this exciting opportunity. To apply, please visit our website and submit your application, including your resume, cover letter, and any required documents. **Equal Employment Opportunity** arenaflex is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and supportive work environment that values diversity, equity, and inclusion. **Accommodations for Individuals with Disabilities** arenaflex is committed to providing reasonable accommodations to individuals with disabilities. If you require accommodations during the application or interview process, please contact us at [email protected]. **Contact Us** If you have any questions or would like more information about this opportunity, please contact us at [email protected]. **Apply Now** To apply for this exciting opportunity, please visit our website and submit your application. We look forward to hearing from you! Apply Job! Apply for this job