Operations Representative II
4 weeks ago
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. The ideal candidate will be able to work in a fast-paced environment, handling both inbound and outbound calls, and be organized, detail-oriented, and able to document cases clearly and accurately in accordance with the program guidelines.
About the Role:
This position involves 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, and conveying resolution to beneficiary or provider via direct communication and professional correspondence.
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
Requirements:
- At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
- Six months of working in a virtual role where the supervisor is not physically in the same space
- Six months of PBM/pharmaceutical benefits related work
- Six months of High Volume Call Center
About NTT DATA:
NTT DATA Services 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.nttdataservices.com/ or LinkedIn to learn more.
NTT DATA Services 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 $[redacted] 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.
-
Heavy Equipment Operator II
4 weeks ago
Providence, Rhode Island, United States TransForce Full timeJob SummaryWe are seeking a highly skilled and experienced Heavy Equipment Operator II to join our team at TransForce. The successful candidate will be responsible for operating, adjusting, servicing, and repairing heavy equipment used to support various construction and maintenance projects.The ideal candidate will have a strong background in operating...
-
Automation Technician II
1 month ago
Providence, Rhode Island, United States We Make RI Partners Full timeJob Summary:We are seeking a skilled Automation Technician II to join our team at We Make RI Partners. As an Automation Technician II, you will be responsible for installing, setting up, repairing, and maintaining automation equipment in a fast-paced injection-molding environment. You will work as a team member to support automation installation, setup,...
-
Research Project Coordinator II
4 weeks ago
Providence, Rhode Island, United States Care New England Full timeThe Clinical Research Project Coordinator II provides oversight and support in the research and non-clinical administrative aspects of the project.Key responsibilities include:Implementing and overseeing the daily operations of the studyMonitoring patient research and dataCoordinating with healthcare professionals and business services teamsCare New England...
-
Assistant Coach II-Men's Baseball Position
4 weeks ago
Providence, Rhode Island, United States Johnson and Wales University Full timeJob SummaryJohnson & Wales University seeks a highly motivated Assistant Coach II-Men's Baseball to join our team. The successful candidate will work closely with the head coach to supervise and develop an intercollegiate varsity team, ensuring a positive and competitive experience for student athletes.Key ResponsibilitiesAttend and assist with practices and...
-
Clinical Research Project Coordinator II
4 weeks ago
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary: The Clinical Research Project Coordinator II provides oversight and support in the research and non-clinical administrative aspects of the project. The incumbent implements and oversees the daily operations of the study, which include monitoring patient recruitment, monitoring protocols, receiving and shipping samples, and supervising staff. The...
-
Data Analyst II Position
4 weeks ago
Providence, Rhode Island, United States State of Rhode Island Full timeJob SummaryThe State of Rhode Island is seeking a highly skilled Data Analyst II to join our team in the Executive Office of Health and Human Services. As a Data Analyst II, you will be responsible for maintaining the EOHHS database security, organizing database recovery and backup procedures, and updating the ecosystem's database tables. This role requires...
-
Global Product Strategy Specialist
1 month ago
Providence, Rhode Island, United States Kids II Full timeAbout the RoleWe are seeking a highly organized and detail-oriented Global Product Strategy Specialist to join our team at Kids2. In this role, you will play a critical part in supporting the Product teams with organizing, assembling, and reviewing physical product samples, sales presentation preparation, and logistical planning.Key...
-
TSV Client Representative
1 month ago
Providence, Rhode Island, United States eTeam Full timeJob DescriptionAs a TSV Client Representative, you will be responsible for ensuring the smooth operation of our offshore projects. This role requires strong communication skills, a high focus on quality and safety, and the ability to work effectively in a team environment.Key Responsibilities:Maintain accurate records of daily activities and ensure that all...
-
Public Safety Officer II Position
1 month ago
Providence, Rhode Island, United States Rhode Island School of Design Full timeJob SummaryRhode Island School of Design (RISD) is seeking a highly skilled Public Safety Officer II to join its Public Safety Department. As a valued member of the RISD community, this position plays a critical role in maintaining a safe campus environment and supporting the educational mission of the College.Key ResponsibilitiesDevelop a thorough knowledge...
-
Route Sales Representative
1 month ago
Providence, Rhode Island, United States Calise Bakery Full timeJob OverviewAs a Route Sales Representative at Calise Bakery, you will be responsible for delivering our fresh bread and roll products to customers in the retail, restaurant, and institutional channels. This is a great opportunity to join a dynamic team and contribute to the success of our company.Key ResponsibilitiesDeliver products to customers in a timely...
-
Customer Service Representative II
4 weeks ago
Providence, Rhode Island, United States NTT DATA Full timeJob SummarySolid 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...
-
Supply Chain Operations Specialist
4 weeks ago
Providence, Rhode Island, United States Brown University Health Full timeJob SummaryUnder the general supervision of Brown University Health Supply Chain Operations Leadership, the Supply Chain Procedural Technician provides high-level customer service and operational support to perioperative services and supporting procedural departments.Key ResponsibilitiesMaintains quality assurance and practice standards in accordance with...
-
Verizon Sales Representative
4 weeks ago
Providence, Rhode Island, United States Resolve Visionary Full timeRole OverviewWe are seeking a skilled Verizon Sales Associate to join our team at Resolve Visionary. As a key member of our sales team, you will play a vital role in connecting our customers with the latest wireless products and services.Key ResponsibilitiesInitiate contact with potential, current, and former customers to provide a comprehensive...
-
Mechanical and Electrical Lab Specialist
4 weeks ago
Providence, Rhode Island, United States Nordson Full timeAt Nordson, we're looking for a skilled and detail-oriented individual to join our EFD team as a Lab Technician II. This role is perfect for someone who is passionate about helping our customers succeed and is eager to work in a collaborative environment.The Lab Technician II will be responsible for preparing design prototypes, conducting evaluations, data...
-
Route Sales Representative
4 weeks ago
Providence, Rhode Island, United States Smitty's Service Inc Full timeJob SummaryAs a Route Sales Representative at Smitty's Service Inc, you will be the face of our brand, delivering exceptional customer service and building strong relationships with our valued customers. Your primary responsibility will be to ensure timely deliveries and provide support to our customers on assigned routes.Key ResponsibilitiesDeliver products...
-
Customer Service Representative
1 month ago
Providence, Rhode Island, United States Sonic Healthcare Full timeJob Summary:We are seeking a highly skilled and motivated Customer Service Representative to join our team at Sonic Healthcare USA. As a key member of our Sales Department, you will be responsible for providing exceptional customer-focused service, managing daily administrative tasks, and championing safety, compliance, and quality control.About the...
-
Route Sales Representative
4 weeks ago
Providence, Rhode Island, United States Smitty's Service Inc Full timeJob SummaryAs a Route Sales Representative at Smitty's Service Inc, you will be the face of our brand, delivering high-quality waffle products directly to our valued customers. Your primary responsibility will be to build strong relationships with customers, ensuring timely deliveries and providing exceptional customer service to uphold our reputation for...
-
Patient Information Services Representative
4 weeks ago
Providence, Rhode Island, United States Lifespan Full timeJob SummaryWe are seeking a highly skilled and compassionate Patient Information Services Representative to join our team at Lifespan. As a key member of our front desk team, you will be the first point of contact for patients, guests, and visitors, providing accurate directions, responding to telephone inquiries, and accessing computer records for patient...
-
Customer Service Representative
4 weeks ago
Providence, Rhode Island, United States TD Bank Full timeJob Summary:The Customer Service Representative will work in a TD Store location and play a key role in delivering legendary customer experiences while processing everyday banking transactions with accuracy and efficiency. The ideal candidate will be able to educate customers on TD's products and services or refer them to a partner for specialized...
-
Customer Service Representative
2 weeks ago
Providence, Rhode Island, United States U-Haul Full timeCustomer Service Representative Job DescriptionAt U-Haul, we're searching for a talented Customer Service Representative to join our team. As a key member of our U-Haul center, you'll play a crucial role in delivering exceptional customer experiences and ensuring our customers receive the support they need. Key Responsibilities:Assist customers with U-Haul...