Job Description

Job Responsibilities:

• Ability to work in a fast-paced environment, handling high volume of both inbound and outbound calls and work offline if the business needs.
• Solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing.
• Must be organized, detail-oriented and able to document cases clearly and accurately in accordance with the program guidelines. Good communication skills are essential, both internal and external.
• Knowledge of Medicare benefits, enrollments and LIS assistance.
• Plans and organizes work assignments, set priorities and completes work with a minimum of supervision. Adheres to the service policy and principles of the company, as well as the program guidelines set by the department.
• Participates in cross-training to perform all roles within the department. Communicates effectively and professionally with our program partners to assure the best possible service for our patients and partners. Other duties as assigned.
• Training and working virtually.
• Utilizing multiple software systems to complete Medicare case.
• Meeting or exceeding government mandated timelines.
• Complying with turnaround time, productivity and quality standards.
• Conveying resolution to beneficiary or provider via direct communication and professional correspondence.
• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance. ;

Skills:

• At least 2 years of healthcare and /or Health call center experience that includes problem resolution, business writing, quality improvement and customer service.
• 6 months of working in a virtual role where the supervisor is not physically in the same space.
• 6 months of PBM/pharmaceutical related work strongly desired.
• 6 months of High-Volume Call Center strongly required.

Education/Experience:

• High School Diploma or GED required. Associate’s degree in business, Accounting or equivalent work experience preferred.

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