Medicare Part B Representative
Medicare Part B Representative
Managed Staffing, Inc.
United States
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See who Managed Staffing, Inc. has hired for this role
Location: 100% Remote (CST or EST)
Position Summary: As a Medicare Part B Representative, you will work closely with healthcare providers to process Organization Determination (OD) and drug benefit exception requests in a call center environment. In this Clinical Representative role, you will play a meaningful role in ensuring member, prescriber, and client satisfaction. You will perform all work in accordance with Medicare Part B guidelines.
Duties
Position Summary: As a Medicare Part B Representative, you will work closely with healthcare providers to process Organization Determination (OD) and drug benefit exception requests in a call center environment. In this Clinical Representative role, you will play a meaningful role in ensuring member, prescriber, and client satisfaction. You will perform all work in accordance with Medicare Part B guidelines.
Duties
- Work incoming cases via fax to process coverage requests from members or prescribers.
- Conduct outreach to patients and providers, obtaining additional information needed to process requests.
- Research and correct any issues found in the overall process.
- Raise issues to Organization Determination Clinical Pharmacists and Management team as needed.
- Read, analyze, and interpret general business correspondence, technical procedures, and governmental regulations.
- Solve practical problems and deal with multiple concrete variables in standardized situations.
- Perform basic mathematical calculations.
- Ensure all cases are properly closed.
- Interpret a variety of work instructions provided through multiple mediums.
- Anticipate needs and resolve issues with urgency to meet quality and production standards.
- Provide schedule flexibility including rotations through nights, weekends, and holiday coverage.
- 6+ months of customer service experience.
- 6+ months of working in a virtual role where the supervisor is not physically in the same space.
- 6+ months of PBM/pharmaceutical related work strongly desired.
- Experience with Medicare Part B is a must.
- High level of attention to detail.
- Strong verbal and written communication skills.
- Ability to problem solve in a dynamic work environment.
- Ability to project a professional business image through phone interactions and internal communication.
- Verifiable High School Diploma or GED required.
- Flexibility to work any shift between 7:00am-8:00pm CST (Monday - Friday) and alternate weekends Saturday and Sunday.
- Training hours: Monday - Friday, 8:00am - 4:30pm CST.
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Seniority level
Entry level -
Employment type
Contract -
Job function
Health Care Provider -
Industries
Hospitals and Health Care
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