San Antonio, TX
- Eligibility Verification is responsible for researching and resolving mail order and retail prescriptions that will not process because there is an issue with the member's insurance coverage.
- Our department is the final step in a long process in order to ensure we meet our member's needs and process or reject their prescriptions accurately.
- Responsible for investigating and resolving eligibility issues on multiple platforms in order to allow requests to continue processing.
- This individual will communicate directly with our clients via phone, fax and/or email to ensure that eligibility information on file for the participant is accurate.
- Interacts with internal and external customers.
- Primarily working Mail Order, Retail, Phones and Keying Projects.
- The Eligibility Verification Team manages member s insurance eligibility by consulting with the Benefits Offices for verification as well as manually updating the files for those members.
- The department receives requests in a variety of different ways: Mail Orders (EDQ queue), Resolution Manager Tasks (retail prescriptions), and Incoming Calls (benefits offices only).
- The Enrollment Rep I ensures that members are able to fill their mail order and retail store prescriptions without actually interacting with any members.
- This is a business to business research process.
- You will be sitting at your own cube that is not shared, for the duration of your shift.
- There are two 15 minutes breaks, one in the morning, one in the afternoon and a 45 minute lunch at midday.
- 100% of the work is computer based and you are provided dual monitors.
- On average you will receive about 10-20 incoming calls during your 8 hour shift.
- The majority of your work will be pulling from our error queue and reaching out to external contacts through phone calls, emails and faxes.
- Candidates must have 2 years Customer Service Call Center experience.
- Basic Excel, Word and Outlook skills required.
- 9, 000 ksph at 99% accuracy.
- Team player.
- Attention to detail.
- Quick paced typing.
- Ability to multitask.
- Very detail oriented.
- Ability to work independently.
- Respectful of peers and superiors.
A-Line Staffing Solutions