Representative II, Med D Prior Auth IB Phone Tech - US Tech Solutions, Inc.

Job Description
In this role, you will be responsible for:
• 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.
 
Responsibilities:

• Training and virtual work
• Utilizing multiple software systems for Medicare appeals case reviews
• Meeting government-mandated timelines
• Compliance with turnaround time, productivity, and quality standards
• Resolving issues via direct communication with beneficiaries or providers
• Maintaining knowledge of relevant and changing Med D guidance

Required Qualifications:

• Self-sufficiency balanced with the ability to seek help when needed
• Technical capability for troubleshooting and effective communication of results.
• Verbal communication skills with members and prescribers while managing software systems
• Accountability, critical thinking, flexibility, and adaptability
• Efficient time and workload management in a deadline-oriented, fast-paced environment
• Proficiency in multiple computer applications and dual workstation monitor navigation
• Typing speed exceeding 30 WPM
• General business experience of at least two years
• Six months of virtual work experience without physical supervisor presence
• Six months of PBM/pharmaceutical-related work strongly desired

Education:

• High School Diploma or GED required
• Associates degree in Business, Accounting, or equivalent work experience preferred