Job Search Assistant
Patient Benefit Specialist- Remote
KPH Healthcare Services, Inc. • Remote • Posted 3 days ago
Boost your interview chances in seconds
Tailored resume, cover letter, and cheat sheet
Remote • Full-time • $17.50-$19.37/hr • Entry Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Patient Benefit Specialist is responsible for all aspects related to adjudication and billing of specialty prescriptions in a call center environment. This role involves monitoring adjudication queues, contacting members and prescribers on non-covered items, facilitating prior authorization processes, providing clinical services, and ensuring customer satisfaction through resolution of service issues.
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
Required
- High School Diploma or GED
- Past experience in a customer service related field
- 6-12 months experience as a pharmacy technician
- 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
Preferred
- Pharmacy technician or related certification
Full Job Description
**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 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: Must work harmoniously and effectively with fellow employees, supervisors and others you are in contact with
+ Initiative: Must work within supervision guidelines and assume additional responsibilities
+ Flexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned work
+ Adaptability: 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 experiences
+ Involvement: Must enjoy the demands of the job and work with interest and enthusiasm
+ Customer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriately
+ Safety: Must take care of equipment and employ good safety habits
+ Leadership: 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** **.**
Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/13192/patient-benefit-specialist--remote/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866)
**Job Locations** _US-NY-Syracuse_
**Posted Date** _2 days ago_ _(9/16/2024 4:24 PM)_
**_Requisition ID_** _2024-13192_
**_\# of Openings_** _2_
**_Category_** _Customer Service/Support_
**_Location : Location_** _US-NY-Syracuse_
**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 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: Must work harmoniously and effectively with fellow employees, supervisors and others you are in contact with
+ Initiative: Must work within supervision guidelines and assume additional responsibilities
+ Flexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned work
+ Adaptability: 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 experiences
+ Involvement: Must enjoy the demands of the job and work with interest and enthusiasm
+ Customer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriately
+ Safety: Must take care of equipment and employ good safety habits
+ Leadership: 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** **.**
Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/13192/patient-benefit-specialist--remote/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866)
**Job Locations** _US-NY-Syracuse_
**Posted Date** _2 days ago_ _(9/16/2024 4:24 PM)_
**_Requisition ID_** _2024-13192_
**_\# of Openings_** _2_
**_Category_** _Customer Service/Support_
**_Location : Location_** _US-NY-Syracuse_
Search for other jobs like this one:
Search for popular related roles:
Remote Employee Benefit Claims Specialist jobsRemote HR Benefits Specialist jobsRemote Benefits Implementation Services Specialist jobsRemote Payroll & Benefit Specialist jobsRemote Insurance Benefits Specialist jobsRemote Payroll Benefits Specialist jobsRemote HR Benefit Specialist jobsRemote Benefit Claims Specialist jobsRemote Benefits Implementation Specialist jobsRemote Payroll and Benefits Specialist jobs
Search nearby locations hiring for this role:
Patient Benefit Specialist jobs in Cortland, NYPatient Benefit Specialist jobs in Utica, NYPatient Benefit Specialist jobs in South Hill, NYPatient Benefit Specialist jobs in Baldwinsville, NYPatient Benefit Specialist jobs in Newark, NYPatient Benefit Specialist jobs in Oneida, NYPatient Benefit Specialist jobs in Oswego, NYPatient Benefit Specialist jobs in Geneva, NYPatient Benefit Specialist jobs in Ithaca, NYPatient Benefit Specialist jobs in Auburn, NY