Full-Time Health Care Call Center Representative

The Program Specialist II will provide support to patients and doctors for activities related to benefit coverage, payments, reimbursements, denials, and general inquiries.

Essential Duties and Responsibilities:

• Provide dedicated, personalized support via phone and online portal.
• Investigate and answer questions about insurance benefits, coverage, and out-of-pocket costs.
• Assist with payments, reimbursements, denials, and appeals.
• Make outbound calls to customers for additional information.
• Assist with prior authorization, medical necessity, benefit verification, and prior authorization assistance.
• Administer searches for alternate reimbursement resources (state/federal assistance).
• Respond to inquiries from customers, sales representatives, and business partners.
• Maintain a positive and helpful attitude.
• Enter orders, change orders, track shipments, and enter customer notes.
• Process patient assistance applications.
• Complete other tasks and projects as assigned.

Expectations:

• Assist with benefit verifications and prior authorizations.
• Enter orders, change orders, and customer notes.
• Act as the primary contact for healthcare providers to obtain patient enrollment and insurance information.
• Learn and follow company and client policies.
• Focus on results in a professional and ethical manner.
• Be accountable and responsible in work practices and expectations.
• Foster a collaborative and team-oriented attitude.
• Communicate effectively.
• Use innovative critical and creative thinking to solve issues.
• Seek assistance when needed.
• Maintain excellent attendance.
• Obtain a Missouri Pharmacy Technician license (application support provided).

Minimum Knowledge, Skills, and Abilities:

• High School Diploma and 4 years’ experience, or Associate’s Degree and 2 years’ experience in a healthcare setting.
• Excellent oral, written, and interpersonal communication skills.
• Ability to multitask.
• Positive attitude.
• Accurate and detail-oriented.
• Ability to work independently and as a team player.
• Ability to work in a fast-paced environment.
• Strong computer skills (Microsoft Word, Excel, PowerPoint).

Preferred Qualifications:

• Customer service/call center experience
• Patient assistance, reimbursement, or pharmacy benefit management experience
• Medical billing and coding experience

Compensation:

Anticipated base salary range: $20/hour.

What is the last date for applying to the job?

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