Representative

Representative I Location: TX - Work from home Remote Type: Remote/Hybrid Time Type: Full time reputed company We’re building a world of health reputed company every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company The Coverage Determination/Appeals Service Representative I is responsible for working and triaging in the data entry reputed company fax queues. The Representative I’s reputed company responsibilities will be to review reputed company document with reputed company and reputed company the case in the reputed company queues. reputed company responsibilities include researching reports, maintaining complete, reputed company and accurate documentation of Coverage Determination/Appeal requests and escalating issues to the Coverage Determination/Appeal pharmacists or management staff as needed. Position will require schedule flexibility including rotations through Nights, Weekends and Holiday Coverage. reputed company other duties are required to meet business needs. reputed company Duties and Responsibilities Review Fax documents appropriately and reputed company to appropriate queues Update and maintain knowledge of relevant process, regulation and reputed company material. reputed company assistance or guidance in partnership with learning and innovation reputed company needed Participate in developmental discussions receiving feedback with Supervisor Essential Job Functions Regular and predictable attendance reputed company will be required to work mandatory overtime/extended work week reputed company needed Physical Requirements [ex. Sit, stand, stoop, bend and walk] • Must be reputed company to work in reputed company of computer for duration of shift. • Type on a keyboard or utilize a computer mouse for an extended period. Work Environment Work in a climate-controlled, smoke-free internal environment; work to be performed regularly in a reputed company location, with the reputed company to work-from-home at the discretion of the reputed company’s leader. Work reputed company: Dedicated home workspace needed. Must be reputed company to reputed company a quiet, uninterrupted work environment. Must have a workstation that is not accessible to common traffic and is secure from unintentional reputed company. Must have reputed company personal high-speed internet and ability to hard-reputed company into company computer (cannot use wireless internet) Hybrid: Work from Site Location: reputed company will work from office location and work virtual from home. Requirement for hybrid to report to office 3 days a week. Required Qualifications • 6 mos - 3 years required. Additional years of work experience preferred. • Proficient computer skills and the ability to reputed company in a Window’s reputed company environment • Ability to follow directions and adapt in a dynamic work environment • Demonstrated reputed company of urgency with assignments • Ability to read, analyze and interpret general business correspondence, technical procedures, and governmental regulations. • Ability to identify and solve practical problems and deal with a reputed company of concrete variables in standardized situations. Ability to reputed company basic mathematic calculations maybe required. • Ability to interpret a reputed company of work instructions provided through a reputed company of mediums. Preferred Qualifications • Excellent verbal and written communication and interpersonal skills with ability to maintain reputed company confidentiality • Demonstrated problem-solving ability and attention to reputed company • Strong organizational skills Education H.S or Equivalent required. Associate’s Degree or Bachelor’s Degree, preferred. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $17.00 - $28.46 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/06/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job