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Customer Service Representative

1 month ago

Detroit, United States ASK Consulting Full time
Job DescriptionJob Description

"All candidates must be directly contracted by ASK Consulting on their payroll and cannot be subcontracted. We are unable to provide sponsorship at this moment".

Job Title: Customer Service Representative (Prior Authorization Expertise)

Location: Detroit, MI - 48167

Duration: 12 months      

Pay rate:  $ 17.50 ON W2.  

Prefer candidates from EST time zone

Job Description:

Work Schedule:

  • Assigned shifts vary from 7 AM - 8 PM CT.
  • Training hours are from 8 AM - 4:30 PM CT.

Position Summary:

Customer Service Specialist takes in-bound calls from providers, pharmacies, members, etc., providing professional and courteous phone assistance to all callers through the criteria-based prior authorization process. Maintains complete, timely, and accurate documentation of reviews. Transfers all clinical questions, escalations, and judgment calls to the pharmacist team. They will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auths received via fax and ePA, monitoring and responding to inquiries via department mailboxes, and other duties as assigned by the leadership team.

Duties:

  • Customer service focus. Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.
  • Comply with departmental, company, state, and federal requirements when processing all information to ensure the accuracy of information being provided to internal and external customers.
  • Communicate with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).
  • Identify and elevate clinical inquiries to the pharmacist team as appropriate.

Experience:

  • 0-3 years in a customer service or call center environment managing 75 calls/day.
  • Must have an effective and empathetic communication style in managing inbound calls and communications with clients and team members.
  • Computer experience is required with proficiency in Microsoft Outlook, Word, and Excel.
  • Basic alphanumeric data entry skills with attention to accuracy and quality is essential.
  • Intermediate math skills are required with attention to detail and quality essential.
  • Experience in a health care setting or insurance industry is a plus, including knowledge of basic insurance and third-party terms and medical terminology.
  • Ability to work with people in a team environment while meeting individual performance goals.
  • Must be able to read and interpret policies, procedures, and instructions.
  • Effective organizational skills and ability to prioritize a fluctuating workload and competing priorities is essential.

Education:

  • High School Diploma or GED required.
  • Associate's degree in Business, Accounting, or equivalent work experience preferred.

About ASK: ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities

ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.