Remote Healthcare Call Center Representative

Job Title: Remote Healthcare Call Center Representative

Pay: $18.97 an hr | Bi-weekly

Job Type:
• Remote

Shift Options:
• Monday to Friday anytime between 12p-12am CST Training Schedule: Mon-Fri 8a-8pCST

Remote Healthcare Call Center Representative Overview:
• The Representative will work closely with providers to communicate the determination of the prior authorization status on behalf of Medicaid as 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.
• This position makes outbound call to provider offices/staff while providing professional phone assistance to all callers through the criteria based prior authorization process.
• High volume call center, able to process 150 calls minimum daily.

Remote Healthcare Call Center Representative Qualifications: • Minimum 2 years of experience in a high volume call center - healthcare or PBM/prior authorization-related preferred. Must have some familiarity with medical terminology and coding. • Strong Attention to detail • Excellent verbal and written communication and interpersonal skills w/ ability to maintain patient confidentiality • Proficient computer skills and the ability to navigate in a Windows based environment • Ability to follow directions, and adapt in dynamic work environment; ability to adapt to change and remain flexible • Ability to work in a high pressure, time sensitive environment • Project a professional business image, through phone interaction as well as internal communications 7.Demonstrated problem-solving ability and attention to detail • Demonstrated sense of urgency with assignments • Strong organizational skills • Strong telephone skills • Ability to read and understand pharmacy/medical terminology • Ability to read, analyze and interpret general business correspondence, technical procedures and governmental regulations. • Ability to identify and solve practical problems and deal with a variety of concrete variables in standardized situations. Ability to perform basic mathematic calculations maybe required • Ability to interpret a variety of work instructions provided through a variety of mediums • Ability to anticipate needs and resolve issues with urgency • Ability to consistently meet quality and production standards • Displays confidence in the ability to learn complex material • Demonstrates intellectual curiosity through inquiries to ensure deep understanding of the business and deliver accurate results

Remote Healthcare Call Center Representative Benefits:
• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance.
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.

How to Apply:

If you are interested in this position, please apply OR submit your resume to:

Saw Hlaing | [email protected] | 412-790-5425

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