Job Description
Position will be completely remote and is open to all candidates within the US with the exception of Colorado.
Candidates must be able to work according to the EST timezone.
Candidates must have a reliable high speed broadband internet connection Candidates must have a quiet and private space designated for work with the modem in the room as a hard-wired connection is required and a WiFi connection will not suffice.
Candidates should not have time off within the first 4 weeks of training.
In this pivotal role, CSRs respond to phone, fax, and online inquiries from health care professionals to assist them through the medication prior authorization process.
Skills:
Top 4 Non-Negotiable Skills:
Excellent Interpersonal communication skills Attention to detail Critical Thinking Call-Center Experience
1-5 years of Call center experience is preferred, some call center experience is required.
The successful candidate will be able to interact appropriately and efficiently with health care professionals using excellent interpersonal and listening skills, critical thinking, and problem solving skills.
The ability to use computer-based resources in a highly effective manner to educate and provide accurate responses to inquiries is crucial for success.
Collection of structured clinical data for prior authorization and non-formulary exception requests following the guidance provided in our online prior authorization tools and/or corresponding forms.
Initial screening of requests based on guidance given by online prior authorization tools.
Approves prior authorization requests if the data collected meets the approval specifications.
Refers prior authorization requests that do not meet the approval specifications to a Pharmacist for clinical review.
Independently responds to contacts ranging from routine to moderate complexity. May seek assistance with health care professional services issues of substantial complexity.
Performs research to respond to inquiries and interprets policy provisions to determine most effective response using established departmental procedures, HIPAA regulations, and corporate policies.
Keywords:
Education:
High School Diploma or GED Required.
Must be able to work any schedule given between 8:00am – 9:00pm Eastern Monday through Friday.
Flexibility to support extended hours and overtime as determined by business needs in order to meet customer expectations.
Able to maintain excellent attendance throughout 4 weeks of training and beyond.
Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status.
Skills and Experience:
Required Skills:
CALL CENTER CUSTOMER SERVICE
Additional Skills:
DETAIL-ORIENTED
EXCELLENT INTERPERSONAL COMMUNICATION SKILLS PROBLEM SOLVING DATA COLLECTION TECHNICAL PROBLEM SOLVING IN-BOUND CALL CENTER CALL CENTER METRICS CALL CENTER APPLICATIONS CALL CENTER/COMPUTER
Languages:
English
Read
Write
Speak
Minimum Degree Required: Completed High School (Diploma or GED)
Patents: No
Publications: No
Veteran Status: No
Job Requirements
Call Center Data Collect Health Care HIPAA