The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Patient Finance Specialist detailed description:
- Source Patient Assistance program and/or foundation to assist patients in meeting Out Of Pocket responsibility
- Take inbound and make outbound calls related to Patient Assistant Program, billing inquiries, and insurance verification
- Provide customer service (internal/external)
- Documenting case files with complete notes on work
- Complete special projects with varied and complex components as needed
- High School Diploma or equivalent. Less than 3 years of technical and/or customer service experience.
- A Saturday schedule (8am-430pm EST) is requires with one day off through the week.
Scheduled Weekly Hours