Customer Support Specialist

Emploi pas sur LinkedIn

🕒 il y a 3 jours

🧀 Wisconsin – Distant

🧀 Wisconsin – Remote

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

💝 Support Client

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ExactCare

Site WebLinkedInTous les Emplois

501 - 1000 employés

Fondée en 2009

⚕️ Assurance santé

💊 Pharmaceutique

💰 Private Equity Round en 2016-03

Healthcare Insurance • Pharmaceuticals

ExactCare est un leader en gestion de soins pharmaceutiques, spécialisé dans la gestion des médicaments pour les personnes ayant des besoins médicaux complexes et chroniques. Avec des opérations dans les 50 états et à Washington, D. C. , ExactCare soutient plus de 100 000 personnes à l'échelle nationale, les aidant à gérer leurs médicaments en résidences assistées, en établissements de soins de longue durée et à domicile. En partenariat avec des organisations de soins de santé, ExactCare vise à améliorer les résultats cliniques en garantissant une meilleure adhésion aux médicaments, en réduisant les réadmissions et en diminuant les coûts globaux de santé.

Description

• Answer telephone inquiries in a pleasant, professional, and efficient manner assuring exceptional customer service. • Document all incoming calls and dialogue in the claims adjudication software. • Educate clients on plan policies, benefits, and procedures. • Resolve client drug benefit concerns of a medical, financial, or technological nature. • Initiate and facilitate prior authorization requests. • Make outbound calls to pharmacies and plans to facilitate completion of JIRA tickets. • Review after hours calls log-complete any follow up as needed. • Submit JIRA tickets for compound prescriptions. • Submit JIRA tickets to resolve NDC issues (pricing issues, missing NDCs). • Stay current on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines. • Accept other duties as assigned; including but not limited to direct member reimbursement, processing, manual claims, reporting, and researching rejected claims. • Ensures that HIPAA guidelines are followed in every communication with clients.

🎯 Exigences

• Associate’s degree or equivalent combination of education or work experience • CPhT (Certified Pharmacy Technician) Certification preferred • A minimum of 3 years of experience in customer service/member service in a call center or similar • A minimum of 2 years of experience in the healthcare industry • A minimum of 2 years of experience in a pharmacy support role • Knowledge of plan and benefit structures and Medicare guidelines. • Knowledge of pharmacology and pharmacological terms • Excellent communication skills and professionalism when working with clients • Ability to solve problems under pressure by making immediate decisions while on the phone • Detail oriented and able to prioritize workload • Strong computer skills including using word processors, spreadsheets, and database software.

🏖️ Avantages

• Medical, dental and vision coverage effective 1st of the month following date of hire • Flexible spending • Company-paid life insurance and short-term disability • Voluntary benefits • 401(k) • Paid Time Off • Paid holidays