Mindlance
Operations Representative:
Delivers specific delegated technical, administrative, or operative tasks assigned by a supervisor. Participate in preparing and reviewing statements and document related to business operations / Finance Operations. Assists in the production levels and effective processing controls and related reporting in accordance with established procedures. Completes day-to-day tasks without immediate supervision but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.
Administrators: responsible for contributing to day-to-day function to include but not limited to ensuring optimal client experience, communication with multiple departments, prescriber office outreach, measuring and reporting outcomes.
Key Functions:
Subject matter expert on product processes available to answer team's clarifying questions
Identifies areas of opportunity for operational efficiencies to ensure optimal team performance
Supporting departmental projects
Resolve non-routine issues escalated from junior team members
Day-to-day operational functions related to assigned product
Coordination of clinical interventions to include reviewing and sorting progress notes and clinical documents, coordinating assignment with clinical pharmacist, and audit of document formatting for accuracy before delivery to prescribers' office
Contacts prescriber offices to gather information, coordinate delivery of intervention documentation, and schedule teleconferences between prescriber and clinical pharmacist
Responds to inquiries or requests additional information from clients, different departments, and/or others for information and assistance
Senior specific
Delivers straightforward administrative and/or other basic business services in Customer Service. Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. Issues tend to be routine in nature. Good knowledge and understanding of Customer Service and business/operating processes and procedures. Works to clearly defined procedures under close supervision.
Skills Experience in managed care, pharmacy technician or workers' compensation claims would be advantageous Customer service Communication Organization and time management Attention to detail MS Office Products Data entry Competencies Operations Representative (Non-Senior) Align: Plans and Aligns Inspire: Communicates Effectively Develop: Tech Savvy Deliver: Action Oriented Please note we would need to interview individuals with Pharmacy Tech experience. We added this as a required skill under the first bullet under Skills. We need to make sure they understand they are not applying for a contact center, last time everyone we interviewed answered their questions contact center based and we are not. This is a very hands-on, high pace position and we would like that for that to be made clear to the applicants prior to interview please. Also, video interviews will require for the camera to be pointing at them not the ceiling or anywhere else in the room please, we have encountered that as well. If you can help us cascade the info to all agencies participating on what we are looking for, it will be greatly appreciated. Minimum 1-2 years experience. 10 years or more may be overqualified. The Skills and Experience match parameters for the candidate are parsed from the uploaded Job Description. Required Skills AUDIT Additional Skills FINANCE DOCUMENTATION CLINICAL DOCUMENTS SORTING RETAIL SALES TIME MANAGEMENT CLAIMS MICROSOFT OFFICE SUBJECT MATTER EXPERT DATA ENTRY PHARMACY BUSINESS OPERATIONS MANAGED CARE CUSTOMER SERVICE ORIENTED OPERATIONS
EEO:
"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."
Skills Experience in managed care, pharmacy technician or workers' compensation claims would be advantageous Customer service Communication Organization and time management Attention to detail MS Office Products Data entry Competencies Operations Representative (Non-Senior) Align: Plans and Aligns Inspire: Communicates Effectively Develop: Tech Savvy Deliver: Action Oriented Please note we would need to interview individuals with Pharmacy Tech experience. We added this as a required skill under the first bullet under Skills. We need to make sure they understand they are not applying for a contact center, last time everyone we interviewed answered their questions contact center based and we are not. This is a very hands-on, high pace position and we would like that for that to be made clear to the applicants prior to interview please. Also, video interviews will require for the camera to be pointing at them not the ceiling or anywhere else in the room please, we have encountered that as well. If you can help us cascade the info to all agencies participating on what we are looking for, it will be greatly appreciated. Minimum 1-2 years experience. 10 years or more may be overqualified. The Skills and Experience match parameters for the candidate are parsed from the uploaded Job Description. Required Skills AUDIT Additional Skills FINANCE DOCUMENTATION CLINICAL DOCUMENTS SORTING RETAIL SALES TIME MANAGEMENT CLAIMS MICROSOFT OFFICE SUBJECT MATTER EXPERT DATA ENTRY PHARMACY BUSINESS OPERATIONS MANAGED CARE CUSTOMER SERVICE ORIENTED OPERATIONS
EEO:
"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."