Pharmacy Call Center Representative - Remote

Summary

As Pharmacy Call Center Representative - Remote, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.

• Share your expertise as you support the Business Process Services team in claims processing that adheres to policy guidelines 
• Meet production and quality requirements established by clients for timely claims processing 
• Use policy guidelines and criteria established by leadership to evaluate why a claim errored and make an adjudication decision 

What we're looking for

• Knowledge of the fundamental concepts and principles in the medical and/or insurance fields 
• Basic reading and analysis skills to evaluate claims and make adjudication decisions
• Basic computer use skills 
• Ability to multi-task across multiple claims to work efficiently 
• Ability to work independently to meet individual production goals

What you should expect in this role

• Opportunities to travel through your work (0-10%)