Customer Service Representative
Title:
Benefit Investigation Specialist Duration:
3
Months Location:
Pittsburgh, PA 15275 Shift Timings:
8:
00 AM - 4:
30 PM (3 openings) 8:
30 AM - 5:
00 PM (44 openings) 9:
00 AM - 5:
30 PM (4 openings) 9:
30 AM - 6:
00 PM (2 openings)
Job Description:
Responsible for direct contact with Medical Insurance Payers and Pharmacy Benefit Managers in order to identify and document available coverage options for retail and specialty medications.
Maintains high quality customer service standards in compliance with federal and state regulations and guidelines.
Skills:
o Minimum of 1) 2 years' experience in customer service, insurance, benefits, marketing, sales or related area, required, or 2) Bachelor's degree and 1-year of relevant experience o Health care environment with third party benefits verification experience preferred.
o Understanding of commercial insurance concepts including coverage policies, major medical benefits, knowledge of government and patient assistance program, knowledge of and understanding of how to communicate information on health insurance, reimbursements, third party terms and medical terminology is preferred o Highly proficient computer skills.
o Skill in managing email correspondence and personal documentation of research.
o Focus on fundamental analytic and problem-solving skills.
o Excellent time management skills o Strong professional customer services experience o High level of attention to detail o Be a critical thinker who is adaptable, and results driven.
Education:
High school diploma or equivalent, required.
Bachelor's degree preferred What you will do:
o Makes outbound calls to Payers and Pharmacy Benefit Manager in order to verify patient insurance coverage and identify available Medical and Pharmacy benefitso Communicates case details to appropriate internal or external parties once benefit verification is completeo Identify any payer coverage restrictions and potential mechanisms for quickly accessing therapyo Ability to effectively contribute alone or in small work groupso Effectively meets production and time completion goalso Accurately document payer Prior Authorization and Appeals protocolso Participate in special projects and perform additional duties as requiredo Maintain repository of payer or brand specific coverage informationo Participate in training and process improvement initiatives Recommended Skills Analytical Appeals Attention To Detail Business Process Improvement Critical Thinking Customer Service Estimated Salary: $20 to $28 per hour based on qualifications.
Benefit Investigation Specialist Duration:
3
Months Location:
Pittsburgh, PA 15275 Shift Timings:
8:
00 AM - 4:
30 PM (3 openings) 8:
30 AM - 5:
00 PM (44 openings) 9:
00 AM - 5:
30 PM (4 openings) 9:
30 AM - 6:
00 PM (2 openings)
Job Description:
Responsible for direct contact with Medical Insurance Payers and Pharmacy Benefit Managers in order to identify and document available coverage options for retail and specialty medications.
Maintains high quality customer service standards in compliance with federal and state regulations and guidelines.
Skills:
o Minimum of 1) 2 years' experience in customer service, insurance, benefits, marketing, sales or related area, required, or 2) Bachelor's degree and 1-year of relevant experience o Health care environment with third party benefits verification experience preferred.
o Understanding of commercial insurance concepts including coverage policies, major medical benefits, knowledge of government and patient assistance program, knowledge of and understanding of how to communicate information on health insurance, reimbursements, third party terms and medical terminology is preferred o Highly proficient computer skills.
o Skill in managing email correspondence and personal documentation of research.
o Focus on fundamental analytic and problem-solving skills.
o Excellent time management skills o Strong professional customer services experience o High level of attention to detail o Be a critical thinker who is adaptable, and results driven.
Education:
High school diploma or equivalent, required.
Bachelor's degree preferred What you will do:
o Makes outbound calls to Payers and Pharmacy Benefit Manager in order to verify patient insurance coverage and identify available Medical and Pharmacy benefitso Communicates case details to appropriate internal or external parties once benefit verification is completeo Identify any payer coverage restrictions and potential mechanisms for quickly accessing therapyo Ability to effectively contribute alone or in small work groupso Effectively meets production and time completion goalso Accurately document payer Prior Authorization and Appeals protocolso Participate in special projects and perform additional duties as requiredo Maintain repository of payer or brand specific coverage informationo Participate in training and process improvement initiatives Recommended Skills Analytical Appeals Attention To Detail Business Process Improvement Critical Thinking Customer Service Estimated Salary: $20 to $28 per hour based on qualifications.
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