Urgent Need - Excellent Pay!
As a Med B Clinical Representative, you will work closely with healthcare providers to process Organization Determination (OD) and drug benefit exception requests in a call center environment. In the Clinical Representative role, you will play a meaningful role in ensuring member and client satisfaction. You will be performing all work in accordance with Medicare Part B guidelines.
Your responsibilities will include:
-Working incoming cases via or fax to process coverage requests from members or prescribers.
-Conducting outreach to patients and providers, and obtaining additional information needed to process requests.
-Researching and correcting any issues found in the overall process.
-Raising issues to Organization Determination Clinical Pharmacists and Management team as needed.
-Reading, analyzing, and interpreting general business correspondence, technical procedures, and governmental regulations.
-Solving practical problems and dealing with multiple concrete variables in standardized situations.
-Performing basic mathematical calculations.
-Ensuring all cases are properly closed
- Ability to interpret a variety of work instructions provided
through multiple mediums
- Ability to anticipate needs and resolve issues with
urgency and to meet quality and production standards