[Remote] Patient Benefit Specialist- Remote

Note: The job is a remote job and is open to candidates in USA. KPH Healthcare Services, Inc. is a multistate organization focused on healthcare services, and they are seeking a Patient Benefit Specialist to manage the adjudication and billing of specialty prescriptions. The role involves customer service responsibilities in a call center environment, ensuring member satisfaction and resolving payment-related issues.ResponsibilitiesResponsible for monitoring adjudication queue(s)Responsible for contacting members and prescribers on non-covered itemsFacilitate prior authorization process for customersProvide clinical services in TherigySTMCustomer service coverage for incoming calls and directing incoming callsProvides resolution to customer service issues to ensure member satisfactionWork with members to provide resolution to payment related issues on accounts/ordersMaintain and keep reasonable production as determined by supervisorMay assist in orienting and training new employeesResponsible for completing all mandatory and regulatory training programsPerform other duties as assignedSkillsMust be available, and on-time for scheduled work shiftsMust be able to work nights and weekends as requiredMinimum: High School Diploma or GEDPast experience in a customer service related fieldBroad knowledge of medications, physician orders, and pharmacy systemsFamiliar with Enterprise billing options and practices surrounding claim submissionStrong communication skillsOutstanding customer service skillsExcellent organization skillsAbility to multitask and prioritizeExcellent computer and keyboarding skillsSuccessful completion of a pre-employment and/or random drug screening testHIPPA Privacy CourseHIPPA Security CourseFraud, Waste, and Abuse CourseMethGuard CourseHIPPA Privacy CE Mastery ExamHIPPA Security CE Mastery ExamFraud, Waste, and Abuse CE Mastery ExamMethGuard CE Mastery ExamCooperation: Must work harmoniously and effectively with fellow employees, supervisors and others you are in contact withInitiative: Must work within supervision guidelines and assume additional responsibilitiesFlexibility: Must be willing to work variable work schedules, nights and weekends, assist others as requested and available, and be willing to perform all assigned workAdaptability: Must respond to new situations in a positive way, accept change, support new ideas, master new routines and grasp explanations, apply current knowledge in new environments and experiencesInvolvement: Must enjoy the demands of the job and work with interest and enthusiasmCustomer Service: Must provide superior customer service (for Noble customers, fellow employees and business partners), listen attentively to their needs and respond appropriatelySafety: Must take care of equipment and employ good safety habitsLeadership: Must gain acceptance of ideas and accomplish goals through subordinates, peers and teamsPharmacy technician or related certification6-12 months experience as a pharmacy technicianCompany OverviewKPH Healthcare Services, Inc. It was founded in 1903, and is headquartered in East Syracuse, New York, USA, with a workforce of 1001-5000 employees. Its website is https://www.kphhealthcareservices.com/en/.



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