Operations Representative II

4 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. 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.



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