Sobre esta vaga de Pharmacy Claims Representative 2 - Patient Financial Services na CenterWell
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The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Use your business knowledge to help analyze data and provide financial support. Humana is seeking a Patient Finance Specialist that will work on the behalf of CenterWell Specialty Pharmacy customers, develop relationships with foundations and manufacturers, and provide internal customer support for the entire Pharmacy.Location: Remote Arizona or Ohio only
Shift: Must be able to work an 8 hour shift between 8am and 8pm EST Monday-Friday. Overtime may be required during peak season.
The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Patient Finance Specialist detailed description:
- Source Patient Assistance programs and/or foundations to assist patients in meeting Out of Pocket responsibility
- Take inbound and make outbound calls related to Patient Assistant Programs, billing inquiries, and insurance verification
- Provide customer service (internal/external)
- Documenting case files with complete notes on work
- Complete special projects with varied and complex components as needed
Use your skills to make an impact
Required Qualifications
- 1 or more years of customer service experience handling both incoming and outgoing phone calls in a professional setting
- Comprehensive knowledge of Microsoft Products including Word, Excel and Outlook
- Intermediate to High level of Windows Based system navigation
Role Desirables
- Bachelor’s Degree in Finance, Accounting or a related field
- Pharmacy Technician Certification
- Previous Healthcare and/or Mail Order Pharmacy experience
- Pharmacy Claims experience
- Fluency in Spanish
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
