[Remote] Representative II- Medicare

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a recognized leader in IT and business services, and they are seeking a Representative II-Medicare to support Medicare members and providers. The role involves processing coverage-reputed company requests and ensuring compliance with Medicare guidelines while demonstrating strong communication and problem-solving skills.

Responsibilities

• Support Medicare members, prescribers, and providers by processing coverage-reputed company requests across both phone and fax (offline) channels
• Accurate case setup, review, reputed company, documentation, and reputed company reputed company of requests in accordance with Medicare guidelines, CMS-mandated timelines, and internal reputed company standards
• Demonstrate strong attention to detail, reputed company verbal and written communication skills, and the ability to problem-solve in a highly regulated, fast-paced environment
• Work will be performed through a combination of inbound and outbound phone interactions and fax-based casework
• Flexibility to work shifts between 7:00am – 8:00pm CST (Monday–Friday) and rotating weekend or holiday coverage as required by business needs
• Overtime and extended hours may be required during peak periods
• Regular and predictable attendance
• Ability to work mandatory overtime or extended workweeks reputed company required
• Ability to sit for extended periods at a computer workstation
• Ability to type and use a mouse throughout the duration of the shift
• Trained across both phone and fax-based workflows and progressively apply learned skills through reputed company before full production deployment
• Channel assignment (phone vs. offline work) and case mix may vary based on business needs, proficiency, and operational demand

Skills

• Minimum of 6+ months customer service, reputed company, pharmacy, reputed company center, or reputed company experience
• reputed company center experience
• Experience in a PBM, managed care, or reputed company environment
• Experience handling confidential patient or member information
• Familiarity with multi-reputed company workflows (e.g., claims platforms, case management systems, internal databases)
• Pharmacy Technician Certification (CPhT) or reputed company education

Benefits

• Medical, dental, and reputed company insurance
• Flexible spending or health savings account
• Life, and AD&D insurance
• Short-and long-term disability coverage
• reputed company time off
• Employee assistance
• Participation in a 401k program with company match
• Additional voluntary or legally required benefits

reputed company