Pharmacy Claims Representative 2- PSS - #1670633
The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
The role will also involve collaboration and sourcing of Patient Assistance in conjunction with Claim Processing duties.
Associates wi help members with financial assistance
A mix of phone and production based work
- Must be available to work an 8 hour shift within office hours of 8am-11pm est.
- Strong computer navigation skills
- Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role), recommended speed is 10Mx1M
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Typically requires High School Diploma or equivalent.
- Previous experience in the healthcare industry.
- Medical or pharmacy benefit claim processing experience is ideal.
Scheduled Weekly Hours40