Eligibility Lead Representative

Pyramid Consulting, Inc

🇬🇧 United Kingdom | 🇺🇸 United States

Hybrid

Staff / Principal

2 days ago

Outlook
Excel
prior authorization
medical terminology
CPT

Health insurance
Pension

2 days ago

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Immediate need for a talentedEligibility Lead Representative. This is a06+ Months Contract opportunity with long-term potential and is located inBirmingham, AL (Hybrid). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-30726

Pay Range: $25.18/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

Use your knowledge of thehealthcare industry,Prescription Benefit Programs,pharmacy coverage,Reimbursement, andInsurance processes to ensure patients get their specialty medication.
Manage constant inbound and outbound calls while meeting quality and production metrics.
Utilize advanced technical skills to navigate through multiple systems, applications, and platforms simultaneously.
Exercise independent judgment in managing escalated patient or client complaints, escalating further if needed.
Be available to work any shift between 7am to 8pm CST, Monday-Friday

Key Requirements and Technology Experience:

1+ years ofcustomer service experience – Required
High school diploma or GED – Required
Proficiency withMicrosoft Office products (Word, Outlook, Excel) – Required
Experience navigating multiple systems and platforms – Required
Pharmacy Technician experience or license – Highly preferred
2+ years of experience withPrescription Benefit Programs,Pharmacy Coverage,Prior Authorization,Eligibility, orInsurance processes – Preferred
2+ years of experience inhealthcare,medical terminology,CPT, andICD codes – Preferred
Strongcustomer service,healthcare/insurance knowledge, andsoft skills are top non-negotiable skills for this role.

Our client is a leadingHealthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.

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Eligibility Lead Representative · Pyramid Consulting, Inc

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