
1001 - 5000 employees
âď¸ SaaS
đ¤ B2B
SaaS ⢠B2B
Fuze Health is a technology-enabled healthcare company that builds digital platforms and services to connect patients with care providers, health resources, and treatments. It partners with providers, employers, health plans and life sciences companies to deliver patient-centered, personalized care, improve outcomes, and modernize healthcare delivery through software and services.
đĽ 16 minutes ago
đť Alaska, District of Columbia, +11 more states â Remote
đľ $19 - $22 / hour
â° Full Time
đ˘ Junior
đŤđ¨âđ No degree required
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1001 - 5000 employees
âď¸ SaaS
đ¤ B2B
SaaS ⢠B2B
Fuze Health is a technology-enabled healthcare company that builds digital platforms and services to connect patients with care providers, health resources, and treatments. It partners with providers, employers, health plans and life sciences companies to deliver patient-centered, personalized care, improve outcomes, and modernize healthcare delivery through software and services.
⢠Respond to all patient and customer inquiries through phone, messaging, and internal systems, providing accurate information and timely resolutions ⢠Review and resolve escalated problem orders to identify root causes and implement effective solutions ⢠Interact with patients regarding prescription claims, order status, and shipping updates with professionalism and empathy ⢠Manage inbound calls from patients, insurance partners, and customers; route calls to appropriate departments as needed ⢠Work closely with internal teams to ensure smooth workflows and provide operational support when needed ⢠Maintain a positive, empathetic, and professional attitude in all interactions to promote a patient-first experience ⢠Strive to exceed key performance indicators (KPIs) and service-level expectations for both internal and external partners ⢠Demonstrate flexibility in a fast-paced environment and embrace new challenges and opportunities for professional development ⢠Perform comprehensive pharmacy billing functions across both pharmacy and medical benefits ⢠Conduct benefits investigations to verify patient coverage, eligibility, and reimbursement requirements ⢠Prepare and submit prior authorizations (PAs) in accordance with payer-specific guidelines and timelines ⢠Manage claims adjudication processes, including review, troubleshooting, and resolution of rejected or denied claims ⢠Coordinate and support patient access through copay assistance programs and other financial support resources
⢠High School Diploma or GED equivalent required ⢠1+ year of customer service experience (healthcare or pharmacy experience preferred) ⢠Strong phone and messaging etiquette with a proven ability to deliver outstanding customer support ⢠Excellent written and verbal communication skills for effective interaction with patients, customers, and team members ⢠Detail-oriented with strong organizational and problem-solving abilities ⢠Ability to work collaboratively in a team environment and build strong professional relationships ⢠Self-driven and comfortable working with complex systems in a remote work environment ⢠Adaptable to change and capable of managing multiple priorities in a fast-paced setting ⢠Experience in pharmacy-related customer service (preferred)
⢠dental ⢠vision ⢠multiple group medical plans to choose from ⢠401(k) retirement savings plan ⢠group life insurance ⢠accidental death and dismemberment (AD&D) insurance ⢠flexible spending account (FSA) ⢠health savings account (HSA) ⢠commuter benefits ⢠employer-paid short-term (STD) and long-term disability (LTD) insurance ⢠additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program) ⢠flexible vacation time ⢠accrued paid sick time ⢠10 paid holidays ⢠2 floating holidays for full time non-exempt employees ⢠eight weeks of paid parental leave for eligible employees ⢠additional paid weeks for the birthing parent ⢠4 weeks paid caregiver leave ⢠Lifestyle Spending Account allowance each month
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