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Member Service Advocate

Convey Health Solutions Yuma, AZ

The Customer Service/Member Service Advocate receives inbound calls from beneficiaries enrolled into a PDP or MAPD program. Assist beneficiaries with updating account information, providing plan information, resolving issues with utilization of the plan, and taking new orders or reorders for products sponsored by the plan(s), e.g., OTC
* ESSENTIAL DUTIES AND RESPONSIBILITIES
* Update account information such as billing options and changes of address or phone numbers.
* Answer questions pertaining to mailings sent out by the company periodically.
* Advise providers on how to get prior authorizations on medicines prescribed with restrictions such as step therapy and quantity limits.
* Assist pharmacies with prescription denials and errors and verifying benefits.
* Make concise and detailed notations as it pertains to member records.
* Look up medicines on the formulary to verify if they are covered, the tier and copay level, and if a drug is not covered provide an explanation as to why.
* Submit mail requests for beneficiaries such as ID cards and formularies.
* Educate beneficiaries on how the plan works, including benefits, cost sharing, and levels of coverage.
Research premium billing discrepancies and prescription claims processed
* High school diploma or equivalent preferred.
* Minimum six months customer service experience is required;
* call center experience is preferred;
* healthcare and/or pharmacy industry experience a plus;
* or any equivalent combination of related training and experience.
* Above average computer skill is required, including the ability to work in a Windows environment and multitask within multiple software programs simultaneously.
Bilingual (Spanish) helpful, but not required.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Convey Health Solutions, Inc.
Yuma, Arizona

Convey Health Solutions

Address

Yuma, AZ
85366 USA
Posted: February 22, 2019