Patient Benefit Specialist- Remote

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  "remote_policy": "remote",
  "salary_period": "hour",
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    "url": "https://kphcareers-kphhealthcareservices.icims.com/jobs/13192/patient-benefit-specialist--remote/job",
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    "title": "Patient Benefit Specialist- Remote",
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    "datePosted": "2024-09-16T04:00:00.000Z",
    "description": "<h2>Overview</h2>\n<p><strong>Scope of Responsibilities: </strong>Works under general supervision.  Follows standard procedures to accomplish assigned tasks.  May assist in orienting and training employees </p>\n<p> </p>\n<p><strong>Job Summary:</strong> Responsible for all aspects related to adjudication and billing of specialty prescriptions in a call center environment.    </p>\n<h2>Responsibilities</h2>\n<p><strong>Job Duties: </strong></p>\n<ul>\n <li>Responsible for monitoring adjudication queue(s)</li>\n <li>Responsible for contacting members and prescribers on non-covered items</li>\n <li>Facilitate prior authorization process for customers</li>\n <li>Provide clinical services in TherigySTM</li>\n <li>Customer service coverage for incoming calls and directing incoming calls </li>\n <li>Provides resolution to customer service issues to ensure member satisfaction</li>\n <li>Work with members to provide resolution to payment related issues on accounts/orders</li>\n <li>Maintain and keep reasonable production as determined by supervisor </li>\n <li>May assist in orienting and training new employees</li>\n <li>Responsible for completing all mandatory and regulatory training programs</li>\n <li>Perform other duties as assigned</li>\n</ul>\n<h2>Qualifications</h2>\n<p><strong>Attendance Requirements:</strong></p>\n<ul>\n <li>Must be available, and on-time for scheduled work shifts. </li>\n <li>Must be able to work nights and weekends as required. </li>\n</ul>\n<p><strong> </strong></p>\n<p><strong>Educational Requirements:</strong></p>\n<ul>\n <li>Minimum: High School Diploma or GED</li>\n <li>Preferred: Pharmacy technician or related certification</li>\n</ul>\n<p> </p>\n<p><strong>Experience:  </strong></p>\n<ul>\n <li>Past experience in a customer service related field</li>\n <li>6-12 months experience as a pharmacy technician</li>\n</ul>\n<p> </p>\n<p><strong>Special Conditions of Employment:</strong></p>\n<ul>\n <li>Drug test</li>\n <li>Initial and continuous exclusion and sanction/disciplinary monitoring</li>\n <li>Any and all additional eligibility requirements based on the specific position</li>\n</ul>\n<p> </p>\n<p><strong>Job Skill Requirements: </strong></p>\n<ul>\n <li>Broad knowledge of medications, physician orders, and pharmacy systems</li>\n <li>Familiar with Enterprise billing options and practices surrounding claim submission</li>\n <li>Strong communication skills </li>\n <li>Outstanding customer service skills</li>\n <li>Excellent organization skills</li>\n <li>Ability to multitask and prioritize </li>\n <li>Excellent computer and keyboarding skills</li>\n <li>Successful completion of a pre-employment and/or random drug screening test</li>\n</ul>\n<p><strong><u> </u></strong></p>\n<p><strong>Required Training:</strong></p>\n<ul>\n <li>HIPPA Privacy Course </li>\n <li>HIPPA Security Course</li>\n <li>Fraud, Waste, and Abuse Course</li>\n <li>MethGuard Course</li>\n <li>HIPPA Privacy CE Mastery Exam</li>\n <li>HIPPA Security CE Mastery Exam</li>\n <li>Fraud, Waste, and Abuse CE Mastery Exam</li>\n <li>MethGuard CE Mastery Exam</li>\n</ul>\n<p> </p>\n<p><strong>Behavioral Traits Required:</strong></p>\n<ul>\n <li>Cooperation: Must work harmoniously and effectively  with  fellow employees, supervisors and others you are in contact with</li>\n <li>Initiative: Must work within supervision guidelines and assume additional responsibilities</li>\n <li>Flexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned work</li>\n <li>Adaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiences</li>\n <li>Involvement: Must enjoy the demands of the job and work with interest and enthusiasm</li>\n <li>Customer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriately</li>\n <li>Safety: Must take care of equipment and employ good safety habits</li>\n <li>Leadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teams</li>\n</ul>\n<p> </p>\n<p> </p>\n<p><u>Compensation</u></p>\n<p> </p>\n<p>$17.50-19.37 per hour.</p>\n<p> </p>\n<p>The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.  </p>\n<p> </p>\n<p><strong>KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state</strong><strong>,</strong><strong> and federal regulations as it pertains to minimum wage requirements</strong><strong>.</strong></p>",
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          "postalCode": "13206",
          "addressRegion": "NY",
          "streetAddress": "6040 Tarbell Rd.",
          "addressCountry": "US",
          "addressLocality": "Syracuse",
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    "validThrough": "2027-09-16T04:00:00.000Z",
    "employmentType": "FULL_TIME",
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