Delivers straightforward administrative and/or other basic business services in Eligibility. Implements and maintains eligibility for benefits. Implements, updates, and maintains automated, direct connect and/or manual eligibility data. Interacts with internal partners and/or external clients/vendors. Generates reports to identify and resolve discrepancies. Identifies process improvement opportunities for own cases. May negotiate and resolve eligibility with clients. May provide technical support for the electronic processing of eligibility. Ensures customer data is installed accurately and timely. May work with client's format and internal Systems to resolve errors. May interact with Systems to resolve technical issues. General knowledge of manual and automated eligibility. Familiar with reporting tools. Technical understanding of systems. Issues tend to be routine in nature. Good knowledge and understanding of Eligibility and business/operating processes and procedures. Works to clearly defined procedures under close supervision.
Pharmacy background is not necessary but preferred, work at home experience, computer savvy, must be familiar with Microsoft programs specifically Excell & Word, PowerPoint & one note, must be reliable with great attendance. **Candidates will make and take calls with this role, but it is production based, not an inbound phone role or contact center job.**