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Form of workJob Description
Remote Claims Processors for a large Benefit Management organization! Please apply if you have experience processing medical claims, prior authorizations and/or have worked in a fast-paced remote CSR/Data Entry role. Classes start 1/16 and 2/5. This is a 1 year temporary contract with Ultimate Staffing Services. Our client would like to hire successful candidates after 1 year.
The Claims Processing role is all about helping people get the prescribed medications they need. In this role you will be responsible for data processing, documenting, and tracking of requests to process pharmacy transactions.
Pay: $18/hr
Training Hours:
- 4 weeks of paid virtual training will be provided.
- 8:00am to 4:30pm Central Time(Monday through Friday)
Job Responsibilities:
- Review criteria to determine if the request can be approved.
- Accurately enter data regarding Prior Authorization in claims system to ensure appropriate claims will adjudicate
- Provide clinical outcome to the member and the members physician within client specific turnaround times
- Research and respond to rejected pharmacy transactions. Update data in system.
- Perform electronic outreach (e-mail, fax, etc.) to pharmacies and physicians offices to obtain all necessary information related to requests, including occasional member assistance
Qualifications/years of experience:
- Computer background; working experience/known success working and navigating between different applications and/or learning new systems. (May use up to 8 different applications simultaneously per day)
- Quality and attention to details
- Demonstrated organizational and time-management skills
- Basic math skills and general PC knowledge including Microsoft Office, Internet, and email.
- Driven by metrics.
- Looking for someone who wants to grow
- HIGHLY Preferred; Pharmacy Tech, PBM, Health Insurance experience.
Education: Minimum of High School Diploma or GED is required.
All qualified applicants will receive consideration for employment without regard torace, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status.We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.
