Member Care Advocate, Customer Service Representative
TrueScripts Management Services
full-time
Posted on:
Location Type: Remote
Location: Nevada • United States
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Salary
💰 $52,000 per year
About the role
- Account Inquiries & Claims Processing
- Assist TrueScripts' members with pharmacy claims processing and plan benefits
- Receive phone calls/emails from members, clients, pharmacies and/or physician offices
- Troubleshoot claim processing problems and/or inquiries in claims adjudication system
- Respond to website inquiries
- Become proficient in all aspects of claims adjudication system
- Communicate escalated member service concerns to manager
- Account Support QA testing for client transitions/changes
- Complete pharmacy contact sheet for fax notifications
- Claims Logging, Invoicing & Reporting
- Log Specialty Care, Brand Care, Paper Claims, and Fee for Prior Authorizations on SharePoint
- Log Specialty and Non-Specialty Prior Authorization approvals on SharePoint
- Prepare and send weekly/monthly invoices to the Accounting team
- Document actions and outcomes in the client database
Requirements
- High School Diploma, 2-year college degree in related field preferred
- Pharmacy technician or equivalent helpful, not required
- Two years of applicable experience preferred
- Innovative thinking
- Ability to explain plans to members and partnered pharmacies
- Knowledge of claims processing helpful
- Analytical thinking and attention to detail
- Excellent communication and customer relations skills
- Problem solving skills
- Ability to multi-task and prioritize in an ever-changing environment
- Strong computer skills including Microsoft Office (Excel, Word, PowerPoint, Outlook)
Benefits
- A wide range of health insurance options including medical, dental and vision
- A strong salary and bonus program
- A robust 401k and company match
- Transitioning to an ESOP, a team member owned company
- Wellness program including financial incentives, chiropractic and massage services, and fitness stipends
- A cohesive, family-based culture
- Charitable contributions and volunteer time
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingclaims adjudicationQA testinginvoicingreportingdata loggingpharmacy claimsprior authorizationanalytical thinkingattention to detail
Soft Skills
innovative thinkingcommunication skillscustomer relationsproblem solvingmulti-taskingprioritizationadaptability
Certifications
High School Diploma2-year college degreePharmacy technician certification