Pharmacy Claims Representative 2 – Patient Financial Services

This is a fully remote position, open to applicants in Arizona, +1 more state.

📋 Description

• Evaluate pharmacy claims and facilitate payment processing for these claims.

• Investigate and respond to questions regarding pharmacy claims adjudication, including payment methods, co-pay or deductible amounts, and reasons for denial.

• Analyze data and offer financial support.

• Cultivate relationships with foundations and manufacturers.

• Deliver internal customer support for the entire Pharmacy department.

• Identify patient assistance programs and/or foundations to aid patients in fulfilling out-of-pocket responsibilities.

• Handle inbound and outbound calls related to patient assistance programs, billing questions, and insurance verification.

• Provide exceptional customer service to both internal and external clients.

• Maintain detailed documentation of case files.

• Undertake special projects that involve diverse and intricate components.

⛳️ Requirements

• A minimum of 1 year of customer service experience managing both incoming and outgoing calls in a professional environment.

• Extensive knowledge of Microsoft Office products, including Word, Excel, and Outlook.

• Intermediate to advanced proficiency in navigating Windows-based systems.

• Capability to work an 8-hour shift between 8 am and 8 pm EST from Monday to Friday.

• Availability for overtime during peak seasons may be necessary.

• Internet service with at least 25 Mbps download and 10 Mbps upload speed is required.

• A dedicated workspace free from ongoing interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company-recognized holidays and personal days.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance options.

• Additional wellness and healthcare opportunities.

• Flexible remote work arrangement.

• Occasional travel to Humana offices for training or meetings.