Eligibility Lead Representative

***Must be able to work any shift between 7am to 8pm CST, Monday-Friday***

Accredo, a specialty pharmacy line of business within The *** Group, is hiring several Eligibility Lead Representatives. For this demanding customer centric role, you’ll ensure our patients receive prescription insurance coverage for their medication. You’ll handle continuous inbound and outbound calls,navigating multiple technical systems and platforms while gathering information from insurers, doctors, and patients to secure coverage. Your persistence and continuous follow-up will ensure our patients receive this vital medication in a timely manner.

What You’ll Do:

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  Use your knowledge of the healthcare industry, Prescription Benefit Programs, pharmacy coverage, Reimbursement and Insurance processes to ensure patients get their specialty medication

  
  
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  Manage constant inbound and outbound calls exemplifying the highest customer service standards to meet quality and production metrics

  
  
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  Use your advanced technical skills to navigate through multiple systems, applications, platforms and screens simultaneously all while speaking on the phone

  
  
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  Use your independent judgement in managing escalated patient or client complaints and discretion to escalate further if needed

  
  
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  Able to work any shift between 7am to 8pm CST, Monday-Friday - Required

  
  

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  1+ years of customer service experience – Required

  
  
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  Pharmacy Technician experience or license, Highly preferred

  
  
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  2+ years of experience with Prescription Benefit Programs, Pharmacy Coverage, Prior Authorization, Eligibility or Insurance processes, Preferred

  
  
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  2+ years of experience in healthcare, medical terminology, CPT and ICD codes - Preferred

  
  
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  Proficiency with Microsoft Office products (Word, Outlook, Excel) and technical savvy navigating multiple systems and platforms – Required

  
  
• 1-2 yrs in health care/claim processing or PBM-insurance support

Customer service, Health care/Insurance knowledge, Soft Skills are top 3 non-negotiable skills for this role.