Job Summary
A health insurance company has an open position for a Telecommute Subrogation Overpayment Pharmacy Claims Representative 2.
Individual must be able to fulfill the following responsibilities:
- Analyze and answer inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial
- Support overpayment initiatives, including, but not limited to: Medicare Secondary Payer, Commercial COB, Commercial vs Medicare Part B, and Commercial Retro-Term
- Ensure compliance by completing and processing overpayments pursuant to state and federal requirements
Must meet the following requirements for consideration:
- Demonstrated strong verbal and written communication skills, including the ability to tailor communication to audience
- Proven strong organizational and time management skills
- Ability to handle multiple tasks, meet deadlines, and follow-up timely
- Demonstrated passion about contributing to an organization focused on continuously improving consumer experiences
- Ability to build relationships and collaborate with other PCAR areas
- Ability to rngage in outreach to initiate recoveries including: outbound and incoming phone calls, sending and responding to emails, creating and sending letters
