KPH HEALTHCARE SERVICES, INC
Patient Benefit Specialist- Remote
KPH HEALTHCARE SERVICES, INC, Syracuse, New York, United States
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
Responsible for monitoring adjudication queue(s) Responsible for contacting members and prescribers on non-covered items Facilitate prior authorization process for customers Provide clinical services in TherigySTM Customer service coverage for incoming calls and directing incoming calls Provides resolution to customer service issues to ensure member satisfaction Work with members to provide resolution to payment related issues on accounts/orders Maintain and keep reasonable production as determined by supervisor May assist in orienting and training new employees Responsible for completing all mandatory and regulatory training programs Perform 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 GED; Preferred: Pharmacy technician or related certification Experience: Past experience in a customer service related field; 6-12 months experience as a pharmacy technician Special Conditions Of Employment: Drug test; Initial and continuous exclusion and sanction/disciplinary monitoring; Any and all additional eligibility requirements based on the specific position Job Skill Requirements: Broad knowledge of medications, physician orders, and pharmacy systems; Familiar with Enterprise billing options and practices surrounding claim submission; Strong communication skills; Outstanding customer service skills; Excellent organization skills; Ability to multitask and prioritize; Excellent computer and keyboarding skills; Successful completion of a pre-employment and/or random drug screening test Required Training: HIPPA Privacy Course; HIPPA Security Course; Fraud, Waste, and Abuse Course; MethGuard Course; HIPPA Privacy CE Mastery Exam; HIPPA Security CE Mastery Exam; Fraud, Waste, and Abuse CE Mastery Exam; MethGuard CE Mastery Exam Behavioral Traits Required: Cooperation; Initiative; Flexibility; Adaptability; Involvement; Customer Service; Safety; Leadership 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. Note:
This employer is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.
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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
Responsible for monitoring adjudication queue(s) Responsible for contacting members and prescribers on non-covered items Facilitate prior authorization process for customers Provide clinical services in TherigySTM Customer service coverage for incoming calls and directing incoming calls Provides resolution to customer service issues to ensure member satisfaction Work with members to provide resolution to payment related issues on accounts/orders Maintain and keep reasonable production as determined by supervisor May assist in orienting and training new employees Responsible for completing all mandatory and regulatory training programs Perform 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 GED; Preferred: Pharmacy technician or related certification Experience: Past experience in a customer service related field; 6-12 months experience as a pharmacy technician Special Conditions Of Employment: Drug test; Initial and continuous exclusion and sanction/disciplinary monitoring; Any and all additional eligibility requirements based on the specific position Job Skill Requirements: Broad knowledge of medications, physician orders, and pharmacy systems; Familiar with Enterprise billing options and practices surrounding claim submission; Strong communication skills; Outstanding customer service skills; Excellent organization skills; Ability to multitask and prioritize; Excellent computer and keyboarding skills; Successful completion of a pre-employment and/or random drug screening test Required Training: HIPPA Privacy Course; HIPPA Security Course; Fraud, Waste, and Abuse Course; MethGuard Course; HIPPA Privacy CE Mastery Exam; HIPPA Security CE Mastery Exam; Fraud, Waste, and Abuse CE Mastery Exam; MethGuard CE Mastery Exam Behavioral Traits Required: Cooperation; Initiative; Flexibility; Adaptability; Involvement; Customer Service; Safety; Leadership 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. Note:
This employer is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.
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