Equity Staffing Group is currently staffing CSR/Call Center/Pharmacy contractors for remote work (CST Hours). This is contract work with a Fortune 100 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with energetic people in a collaborative environment, we want to speak with you!
Position: CSR/Call Center/Pharmacy
Location: Remote/WFH/CST Hours
Duration: 6 Month Contract to start, potential for extension and/or conversion to FTE
Rate: $16.00/Hr
Start Date: 11/04/2024
Hours:
Training is for 2 weeks.
Training time is 8:00am-5:00pm CST. Monday- Friday.
After training, this job function is 24/7/365.
Most shifts will be from 8am to 6pm, but we may have need weekend shifts. (local time)
Primary Responsibilities:
- Sort electronic copies of incoming fax transmittals, and index them into the appropriate Prior Authorization System (PAS) workbaskets
- Research and identifying member, provider, and drug information across multiple computer systems
- Review Incoming PA faxes and initiate coverage determination requests in a timely manner within SLA
- Perform outbound calls to Providers and/or Members to obtain additional information to resolve Prior Authorization cases. Perform outbound call to Providers and/or to inform them of the outcome of Prior Authorization cases.
Additional Responsibilities:
- Navigate across multiple computer systems to identify information needed for outbound calls to members/providers.
- Make outgoing calls as needed to provide information on prior authorization case outcome, follow-up or consultation such as prior authorization requirements, appeals, etc.
- Educate members / guardians, providers, pharmacy staff on procedures to avoid compliance risk.
- Meet departmental established performance expectations and working independently to complete tasks in a timely manner.
- May include processing member prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary.
- May take incoming calls from members or providers and apply benefit plan criteria in making decisions (approvals / denials) or recommendations; clarify and explain pharmaceutical benefits and procedures.
- May partner with others to gather additional information and / or to interpret clinical guidelines; act as a resource for others
- Incumbents typically are not licensed pharmacy technicians.
- May include licensed pharmacy technicians doing non-technician work
Important Information:
- Training is for 2 weeks. Training time is 8:00am-5:00pm CST. Monday- Friday.
- This training time is subject to change
- Shift after training is an 8 hour shift.
- Candidate must be available as early as 5am and as late as midnight and available for overnight and weekend shifts.
- Candidate will work 5 days a week which may or may not include a weekend day(s).
- There is scheduled Overtime and working on Holidays. Dependent on business needs, candidate could work up to 4 hours a day OT.
- Candidate must have their own home internet access/VPN (internet can be hard wired with Ethernet cord)
- Candidate must also have a secure work space/office in their home
- Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)
- Excellent Attendance is a must
Soft Skills:
Ability to identify problems including complex issues and determine solutions, both independently or in a team / group setting
Communication skills including the ability to consult / advise, demonstrate empathy, and provide clear instructions or directions
Equity Staffing Group is one of the fastest growing Native American owned staffing companies in the United States. We are a certified Minority Business Enterprise (MBE) by the National Minority Supplier Development Council (NMSDC) and the Rocky Mountain Minority Supplier Development Council (RMMSDC).
Equity Staffing Group is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Equity Staffing Group will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.
We welcome you to learn more about our company by visiting www.equitystaffing.com