Job Description

We are looking for a REMOTE HEALTHCARE CALL CENTER REPRESENTATIVE.

START DATE IS 05/17/2021

THIS IS FULLY REMOTE POSITION.

NOTE: YOU MUST HAVE INTERNET TO PERFORM THE JOB DUTIES.

PAY: $14.00

M - F: 8:30 AM - 5 PM CST

REQUIREMENTS:

MUST HAVE CUSTOMER SERVICE EXPERIENCE.

MUST HAVE CALL CENTER EXPERIENCE.

MUST HAVE HEALTHCARE EXPERIENCE.

MUST HAVE BASIC EXPERIENCE IN MS WORD AND MS EXCEL.

FAMILIAR WITH MEDICAL TERMINOLOGY AND KNOWLEDGE OF MEDICAL CODING.

ABILITY TO READ AND INTERPRET BILLING DOCUMENTS.

THE POSITION ALSO REQUIRES AN EXTENSIVE AMOUNT OF DATA ENTRY WORK.

RESPONSIBILITIES:

• The Representative will work closely with providers to process prior authorization (PA), and drug benefit exception requests on behalf of the client and in accordance with Medicare Part D CMS Regulations.
• Must apply information [provided through multiple channels] to the plan criteria defined through work instruction.
• Research and conduct outreach via phone to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close cases.
• Responsible for research and correction of any issues found in the overall process.
• Phone assistance is required to initiate and/or resolve coverage requests.
• Escalate issues to Coverage Determinations and Appeals clinical pharmacists and management team as needed.
• Must maintain compliance at all times with CMS and department standards.
• Position requires schedule flexibility including rotations through nights, weekend and holiday coverage.

​If you are interested, please contact CHIN YANG AT A-LINE STAFFING. Thank you!