Duration: 6 months contract
Shift: *Training schedule is Monday-Friday 8-4:30pm. Regular shift to be determined after training.
Job Description:
The Intake I (IQA) Associate takes in-bound calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of all requests, and transfers all clinical questions and judgement calls to the nurse or pharmacist. The Intake I (IQA) Associate will also assist with other duties such as outbound calls, monitoring/responding to inquiries in mailboxes and other duties as assigned by the leadership team.
Responsibilities:
- Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.
- Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
- Communication with other internal groups regarding determination status and results (nurses, pharmacists, etc).
Experience:
- 0-3 years in a customer service or call center environment managing 75 calls/day.
- Six months of PBM/pharmaceutical related work strongly desired
- At least two years of general business experience that includes problem resolution, business writing, quality improvement and customer service
Skills:
- Prior Authorization
- Medicare and Medicaid
- Call handling experience.
Education:
- High School Diploma or GED required.
- Associates degree in Business, Accounting or equivalent work experience preferred.
