San Antonio, TX

Post Date: 08/22/2017 Job ID: 23224 Category: Pharmacy

Job Description:
  • 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.

Work Environment:
  • 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.

Required Skills
  • 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



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