Customer Service
hace 3 semanas
_**HIGHLY Preferred; Pharmacy Tech, PBM, Health Insurance experience.**_
**Training Overview**:
4 weeks of training learning the process in classrooms setting, two weeks of audits, and potential two additional weeks for audits if needed. There will be support from trainers and senior employees if they have questions as they go through cases while on the floor.
Training Metrics: One - two weeks of audits - hitting 98% accuracy. During this time, they utilize the resources and support provided.
Attendance: Must be in training daily.
**Qualifications/years of experience**:
- Quality and attention to details
- Demonstrated organizational and time-management skills
- Driven by metrics.
- Looking for someone who wants to grow
**Position Overview**:
- Review criteria to determine if the request can be approved;
- Accurately enter Prior Authorization in claims system to ensure appropriate claims will adjudicate
- Provide clinical outcome to the member and the member’s physician within client specific turnaround times
- Perform outreach to pharmacies and physician’s offices to obtain all necessary information related to requests, including occasional member assistance
**Manager Expectations**:
- Attendance is mandatory during training for the success of the employee in the job
- Someone must be open to gaining feedback, and growth conversations
- This role is a desk and computer oriented job
- Each employee has metrics to meet (production and quality)
- Ability to work overtime, weekends and holidays as needed.
**Technology Requirements**:
- dual monitors, toggling between screens.
- Systems that are utilized include; Cover My Meds, RX Claims, BET Website (Benefits Editor Tool), Right Fax, WebEx, Microsoft Office (Excel, Word, PowerPoint, Outlook).
Tipo de puesto: Tiempo completo
Salario: A partir de $15,000.00 al mes
Horario:
- Turno de 8 horas
Prestaciones:
- Horarios flexibles
Idioma:
- Inglés (Obligatorio)
Lugar de trabajo: Una ubicación
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