Eligibility Senior Representative - Accredo - Hybrid (Hawaii)
$39,520–$60,320 year
HybridHonolulu, Hawaii, United States
Job Summary
Facilitate cross-functional resolution of drug coverage issues and proactively research problems impacting revenue optimization. Perform medical and pharmacy benefit verification using internal tracking tools to determine patient onboarding eligibility. Contact benefit providers to gather policy limitations and coordinate services to ensure reimbursement compliance. Provide expert assistance to clients on patient status and serve as a liaison for referral reporting. Handle challenging customer complaints with independent judgment and escalate as appropriate. This role involves 30% to 50% daily incoming and outgoing calls. Candidates must reside on Oahu and work in person twice weekly at the Honolulu office.
Required Qualifications
- High school diploma or GED
- Bachelor's degree preferred
- 2+ years of relevant working experience
- Health care or professional office experience with medical insurance knowledge and terminology preferred
- Advanced problem solving skills
- Ability to work collaboratively with other departments to resolve issues with innovative solutions
- Proven attention to detail skills
- Intermediate data entry skills
- Working knowledge of Microsoft Office Suites
- Excellent phone presentation and communication skills
- Interest and curiosity to learn new skills in a changing environment
- Ability to adapt in a dynamic work environment and make decisions with minimal supervision
- Must live on the island of Oahu
- Ability to work in person
- Required to come into 677 Ala Moana Blvd, Suite 404, Honolulu, HI 96813 office 2 times per week
- Internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload
Desired Qualifications
- Bachelor's degree preferred
- Health care or professional office experience with medical insurance knowledge and terminology preferred
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