- Research claim reject messaging associate with a coverage determination in our adjudication platform
- Transcribe electronic faxes for coverage determinations for pharmacist review in our prior authorization platform
- Place outgoing phone calls to medical office if more information is needed or fax needs to be verified
- Document all information and enter data accurately
- Utilize on line training documents to ensure following current process
- Ensure all time frames are met for coverage determinations
- View day’s schedule in the workforce management software throughout the day which schedules the Coordinator’s breaks, lunches, meetings, team huddles etc. Receive (2) 15 minute breaks, (1) 30 minute break
- Must adhere to this schedule and meet a Schedule Compliance goal of 80% or higher by remaining productive at their workstation.
There are several MyTime codes in the workforce management software for a Coordinator:
- Project (approved projects)
- Tech Issues (PC issues)
During the first 60 days, goal is to work 4 Episodes of Coverage (EOC) per hour in the queue trained. After 60 days, goal increases to 6 EOCs per hour.
Attend all scheduled Huddles, Training Forums and Meetings
Complete timely all training assigned in our learning management software
Come to work daily and start on time
Keys for a Coordinator
o Experience as pharmacy technician or in PBM or healthcare fields a plus
o Must have internet access that is NOT a hotspot
o Must have working smart phone for VPN access
o Stable job history
o Self-motivated, detail oriented and responsible individual who is able to work with minimal supervision
o Ability to identify, research and resolve issues
o Work extended hours during peak times
“EverStaff offers employees Medical, Dental, Vision, Accident, Life, Disability and Cancer insurance coverage.”
“All qualified applicants will receive consideration for employment without regard to race, color, religion, ethnicity, national origin, sex, gender identity, sexual orientation, disability status, protected veteran status or any other protected status under the law.
EverStaff is an equal opportunity employer(M/F/D/V/SO/GI)”
Why Work Here?EVERSTAFF specializes in the recruitment of a variety of professionals in various industries and is a resource for providing the most qualified and skilled individuals to organizations of all sizes. EVERSTAFF strives to optimize our efforts and resources to exceed our clients' and candidates' expectations.
EverStaff offers employees Medical, Dental, Vision, Accident, Life, Disability and Cancer insurance coverage.