Job Responsibilities : Remote Customer Resolution Associate (Work from Home Hiring ASAP)
Salary : 16.47 – $24.71 yearly
Company : Prime Therapeutics
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Customer Resolution Associate
Job Description Summary
This position is responsible for providing assistance with the resolution of authorization and/or claim issues in various work queues resulting from and calls taken from facilities and providers. Acts as liaison between providers, internal departments and specific accounts, clients, and claims department.
Resolves cases in queue due to member eligibility issues, referring provider verification or request, imaging provider verification, redirection, and retro reviews.
Assists with authorization problem resolution through research and facilitating the resolution of the problem in a timely fashion.
Process, forward, trend, and maintain records of authorization issues.
Acts as a troubleshooter to resolve problems among internal departments.
Handles special requests from Customers requiring manual workarounds or specials projects.
Investigates written/verbal complaints involving authorizations, and resolves complex issues with Customers and Providers.
Assists specific accounts who have special processes.
Observes and tracks authorization problem trends and works with internal department for resolution.
Assists with User Acceptance Testing (UAT).
Provides phone back-up coverage for other teams as needed.
Ability to review and interpret multiple contract/account information to successfully resolve issues regarding benefit plan administration; experience with account benefit structures.
Demonstrated ability for problem solving, meeting deadlines, initiative and follow-through.
Excellent written and verbal communication skills.
Knowledge of pharmacy benefits management.
Understanding of customer service performance metrics (ASA, abandonment rate, talk time).
Work Experience – Required:
Claims, Customer Service
Work Experience – Preferred:
Education – Required:
GED, High School
Education – Preferred:
Certifications – Required:
Certifications – Preferred:
Potential pay for this position ranges from $16.47 – $24.71 based on location, experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the “Benefits at a glance” button for more detail.
Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.
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