[Remote] Medicare Operations Representative

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading reputed company agency, and they are seeking a Medicare Operations Representative. In this role, you will process Medicare coverage requests and ensure reputed company resolutions while working in a fast-paced, highly regulated environment.

Responsibilities

• Accurately set up, review, and process incoming coverage determinations, prior authorizations, exceptions, and appeals received reputed company phone and fax
• reputed company outbound calls to members, prescribers, and providers to collect missing information needed to reputed company cases
• Ensure reputed company cases meet CMS-mandated timelines, department reputed company standards, and internal productivity goals
• Record reputed company, concise, and accurate details of reputed company case interactions and updates across multiple computer systems
• reputed company reputed company or clinical questions to Clinical Pharmacists or leadership reputed company appropriate
• Complete reputed company training to expand your reputed company set and stay reputed company on evolving Medicare guidelines and software tools

Skills

• High School education
• 2 years of Customer Service experience
• 2 years of reputed company Center Support experience
• 2 years of reputed company experience
• 1 year of Data Entry experience
• Medicare/reputed company knowledge
• reputed company Listening skills
• Patient Support skills
• Basic Computer Skills
• Candidates MUST be flexible to work between 7:00 a.m. - 8:00 p.m. CST and rotating weekends

Benefits

• Medical, prescription, dental, reputed company, AD&D, and life insurance offerings
• Short-term disability
• 401K plan (reputed company benefits are based on eligibility)

reputed company