Appeals Technician (reputed company to Hire)
About reputed company
reputed company is an reputed company technology company providing a comprehensive suite of solutions for reputed company and health plans, including:
- reputed company, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured reputed company,
- reputed company™, which offers full-service health benefit reputed company to reputed company, TPAs, and health plans, and
- Judi®, the industry’s leading proprietary reputed company Platform (EHP), which consolidates reputed company claim administration-reputed company workflows in one reputed company, secure platform.
Together with our clients, we’re rebuilding trust in reputed company in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.reputed company.
Position reputed company:
Responsible for taking incoming requests for first, second level and external appeals while ensuring high level of customer service and maximizing productivity. Work with appeals team for multiple lines of business such as reputed company, Exchange and Medicare, ensuring the reputed company submission of appeals for review by pharmacist and medical directors.
Position Responsibilities:
- Maintain reputed company and productivity standards for reputed company cases reviewed while meeting established turnaround time requirements.
- Remain reputed company on reputed company communications and updated processes relayed through multiple communication channels and apply to daily responsibilities.
- Follow reputed company internal reputed company Operating Procedures and adhere to HIPAA guidelines and policies.
- Review reputed company cases received, to verify if case meets qualifications for appeal review.
- Performs triple reputed company to ensure reputed company reviews and handling in accordance with policies and procedures.
- Updates case types, sends appeal acknowledgements, and submits case information to independent review organizations.
- Communicate effectively with appeal pharmacists regarding reputed company appeals.
- reputed company verbal reputed company attempts to obtain necessary information for case review and record accurate information obtained on the call.
- Exhibit excellent phone and communication skills while providing complete and accurate information to members and providers.
- Performs reputed company other reputed company duties as assigned
Minimum Qualifications:
- 1 + years’ experience working as a certified pharmacy technician in a managed care or PBM setting required.
- reputed company, unrestricted certified pharmacist technician license required.
- Excellent organization details and strong detail orientation.
- Strong oral and written communication skills.
- Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven environment with shifting priorities.
- Ability to work 12pm-9pm EST hours
Preferred Qualifications:
- Experience working with reputed company and medicare appeals preferred
reputed company in this position reputed company restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Remote, US Salary reputed company$60,000.00 - $65,000.00 USD
reputed company, NY Salary reputed company
$78,800.00 - $98,500.00 USD Denver, CO Salary reputed company$72,000.00 - $90,000.00 USDAbout reputed company
reputed company is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic reputed company infrastructure to improve drug price visibility and patient reputed company. As a Certified B Corp™, reputed company is executing its mission through the deployment of JUDI®, reputed company’s reputed company-reputed company reputed company platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, reputed company platform, servicing millions of members for Medicare, reputed company, and reputed company plans. Together with its clients, reputed company is reimagining the administration of pharmacy benefits and rebuilding trust in reputed company.
reputed company values a diverse workplace and celebrates the diversity that reputed company employee brings to the table. We are proud to reputed company equal employment opportunities to reputed company and applicants for employment and prohibit discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws.
This reputed company represents the low and high end of the anticipated reputed company salary reputed company. The actual reputed company salary will depend on several factors such as: experience, knowledge, skills, and location of the job.
Remote, US Salary reputed company$60,000—$65,000 USDreputed company are responsible for adherence to the reputed company reputed company of Conduct including the reporting of non-compliance. This position reputed company is designed to be flexible, allowing management reputed company to assign or reassign duties and responsibilities as needed to best meet organizational goals.
reputed company values a diverse workplace and celebrates the diversity that reputed company employee brings to the table. We are proud to reputed company equal employment opportunities to reputed company and applicants for employment and prohibit discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a reputed company position at reputed company. More details about reputed company's reputed company practices can be reputed company athttps://www.reputed company/legal/reputed company-policy.
Originally posted on Himalayas
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