Customer Service Representative II

3 weeks ago

Providence, Rhode Island, United States NTT DATA Full time
Job Summary

Solid knowledge of prescription drug reimbursement, including insurance plan types, PBM and major medical benefits, prior authorizations and appeals processing is essential for this role.

Ability to work in a fast-paced environment, handling both inbound and outbound calls, is crucial for success in this position.

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, with knowledge of Medicare benefits, enrollments and LIS assistance.

Plans and organizes work assignments, sets priorities and completes work with a minimum of supervision.

Adheres to the service policy and principles of the company, as well as the program guidelines set by the department.

Participates in cross-training to perform all roles within the department.

Communicates effectively and professionally with our program partners to assure the best possible service for our patients and partners.

Responsibilities
  • Training and working virtually
  • Utilizing multiple software systems to complete Medicare appeals case reviews
  • Meeting or exceeding government mandated timelines
  • Complying with turnaround time, productivity and quality standards
  • Conveying resolution to beneficiary or provider via direct communication and professional correspondence
  • Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
Requirements
  • Six months of PBM/pharmaceutical benefits related work
  • Six months of High Volume Call Center
About NTT DATA

NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas.

As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers.

We are committed to our clients' long-term success.

Visit https://www.nttdata.com or LinkedIn to learn more.

NTT DATA is an equal opportunity employer and considers all applicants without regard to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law.

We are committed to creating a diverse and inclusive environment for all employees.

If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles.

The starting hourly range for this remote role is $[insert range] This range reflects the minimum and maximum target compensation for the position across all US locations.

Actual compensation will depend on a number of factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

This position may also be eligible for incentive compensation based on individual and/or company performance.

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