Job Description
Job DescriptionResponsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.
Responsibilities:
• Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with Company Help Desk Call Center performance metrics.
• Answer incoming providers and beneficiaries’ calls following Call Center scripts, in a timely matter and in accordance with call center performance metrics.
• Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.
• Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.
• Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.
• Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.
• Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment.
Qualifications:
• Pharmacy Technician, Technical or Associate Degree
1 - 2-year customer service or call center experience and healthcare environment (Preferable).
Knowledge:
• Fully Bilingual (Spanish / English written and verbal).
• PC skills (Microsoft System)/System oriented.
Equal Opportunity Employer / Disabled / Protected Veterans
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRi…
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_…
For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Partici…
We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
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Company DescriptionThis company offers growth and a great group of people to work with.
Company Description
This company offers growth and a great group of people to work with.