Pharmacy Appeals Representative- REMOTE

Pharmacy Appeals Representative
September 12, 2022
Shipping Clerk
September 13, 2022

Pharmacy Appeals Representative- REMOTE

  • Florida
  • North Carolina
  • Pennsylvania
  • Texas
  • Ohio
  • Arizona
  • Illinois
  • REMOTE

Will be processing Medicare appeals cases. This is a remote position but candidate must reside in one of the following states: Pennsylvania, Ohio, Florida, North Carolina, Texas, Illinois or Arizona.

Job Requirements:

  • Must have solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing.
  • Previous experience processing appeals is strongly preferred.
  • Ability to work in a fast paced environment, handling both inbound and outbound calls.
  • Must be organized, detail-oriented and able to document cases clearly and accurately in accordance with the program guidelines.
  • Good communication skills are essential, both internal and external.
  • Must have knowledge of Medicare benefits, enrollments and LIS assistance.
  • Plans and organizes work assignments, set priorities and completes work with a minimum of supervision.
  • Accountable and results driven
  • Critical thinker/problem solver
  • Receptive to constructive feedback and flexible in adapting to change
  • Ability to effectively plan, prioritize, and organize time and workload
  • Ability to execute successfully in a deadline-oriented, fast-paced, highly-regulated environment
  • Proficient in navigation of multiple computer applications
  • Proficient use of keyboard, mouse and ability to navigate 2 workstation monitors
  • Must be vaccinated against Covid-19

Preferred Qualifications:

  • At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
  • Six months of PBM/pharmaceutical related work strongly desired

Pay rate: $17.50/hr.

Hours: Must be flexible to work a regular 8 hour shift between the hours of 8:00 am – 8:00 pm EST, Monday – Friday. Rotating weekends are required.

Our Mission:

Choice One Staffing Group offers our employees assistance in finding the best positions for their skills, talents, and experience. It’s simple. At Choice One Staffing Group, People are our PURPOSE and YOUR success is OUR success!

Try us! You’ll find we focus on providing a positive candidate experience from your first contact through the completion of your first assignment and every assignment.

Employee Benefits:

We offer medical, holiday pay, vacation pay, referral bonuses and pre-employment preparation.

Specialized Staffing:

We specialize in Administrative, Light Industrial, Technical, Medical and Hospitality

EEO Policy:

Choice One Staffing Group, Inc. is an equal opportunity employer that prohibits employment discrimination based on race, color, religion, sex, national origin and ancestry, individuals who are 40 years of age and older or qualified individuals with disabilities.

To apply for this job please visit onlineapps2.coatsweb.com.