Welcome page Returning Candidate? Log back in! Patient Benefit Specialist- Remote Job Locations US-NY-Syracuse Posted Date 3 months ago(9/16/2024 4:24 PM) Requisition ID 2024-13192 # of Openings 2 Category Customer Service/Support Location : Location US-NY-Syracuse Overview

Scope of Responsibilities: Works under general supervision.  Follows standard procedures to accomplish assigned tasks.  May assist in orienting and training employees

 

Job Summary: Responsible for all aspects related to adjudication and billing of specialty prescriptions in a call center environment.   

Responsibilities

Job Duties:

Responsible for monitoring adjudication queue(s)Responsible for contacting members and prescribers on non-covered itemsFacilitate prior authorization process for customersProvide clinical services in TherigySTMCustomer service coverage for incoming calls and directing incoming calls Provides resolution to customer service issues to ensure member satisfactionWork with members to provide resolution to payment related issues on accounts/ordersMaintain and keep reasonable production as determined by supervisor May assist in orienting and training new employeesResponsible for completing all mandatory and regulatory training programsPerform other duties as assigned Qualifications

Attendance Requirements:

Must be available, and on-time for scheduled work shifts. Must be able to work nights and weekends as required.

 

Educational Requirements:

Minimum: High School Diploma or GEDPreferred: Pharmacy technician or related certification

 

Experience: 

Past experience in a customer service related field6-12 months experience as a pharmacy technician

 

Special Conditions of Employment:

Drug testInitial and continuous exclusion and sanction/disciplinary monitoringAny and all additional eligibility requirements based on the specific position

 

Job Skill Requirements:

Broad knowledge of medications, physician orders, and pharmacy systemsFamiliar with Enterprise billing options and practices surrounding claim submissionStrong communication skills Outstanding customer service skillsExcellent organization skillsAbility to multitask and prioritize Excellent computer and keyboarding skillsSuccessful completion of a pre-employment and/or random drug screening test

 

Required Training:

HIPPA Privacy Course HIPPA Security CourseFraud, Waste, and Abuse CourseMethGuard CourseHIPPA Privacy CE Mastery ExamHIPPA Security CE Mastery ExamFraud, Waste, and Abuse CE Mastery ExamMethGuard CE Mastery Exam

 

Behavioral Traits Required:

Cooperation: Must work harmoniously and effectively  with  fellow employees, supervisors and others you are in contact withInitiative: Must work within supervision guidelines and assume additional responsibilitiesFlexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned workAdaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiencesInvolvement: Must enjoy the demands of the job and work with interest and enthusiasmCustomer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriatelySafety: Must take care of equipment and employ good safety habitsLeadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams

 

 

Compensation

 

$17.50-19.37 per hour.

 

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.  

 

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.

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