Eligibility Associate

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Job Title : Eligibility Associate

Job Location : 1670 Century Gate Drive Memphis, TN 38134

Duration : 3 months

Shift : Monday to Friday 8 AM - 5 PM

Job Description:
Responsibilities:

The primary function/purpose of this job.
The Eligibility Associate handles incoming calls from clients to enable members to maximize their prescription benefit program. This position enters requests from clients via e-mail, fax, or postal mail. Documents and tracks requests and contacts clients for clarification of requests. Documents client contacts using department data base. Escalates eligibility issues as needed. Audits FET Documentation and manages file transfers from e-mail to Anchor.
Essential Functions:
The 6-10 major responsibility areas of the job.
Weight: (%) (Total = 100%)

1. Handle inbound clients calls and written correspondence regarding member eligibility. Make independent judgments in order to respond to complex or critical client issues. Make appropriate updates to ensure members maximize the use of their prescription benefit program. 50%
2. Maintain accurate and complete documentation of all contacts. This continuously improves the process and reduces potential for legal concerns or payouts. 20%
3. Identify and escalate repetitive questions and /or problems so that corrective action can be pursued and expedited. 10%
4. Work collaboratively with other Eligibility Associates, Eligibility Managers and Account Managers to ensure that best practices are shared. 5%
5. Maintain File Transfers from e-mail to Anchor and track the progress 5%
6. Complete FET Documentation Audits and provide results to Management 5%
7. Complete other projects and additional duties as assigned. 5%

Scope of Job:
Individual will work with direction from management to appropriately respond to and address member eligibility. This position will also be responsible for making proper determination of when to escalate critical concerns.

Qualifications:
Minimum requirements to competently perform the key responsibilities of this job in terms of educational background, work experience, licenses/certifications or other knowledge, skills, and abilities.

Minimum Qualifications to Enter the Job:
Formal Education and/or Training:
High school degree or equivalent

Experience:

0 - 5 years’ experience in customer service setting

Knowledge and Abilities:
Good typing skills and 10 key experience; Excellent oral communication and customer service skills; Detail oriented; Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions; Strong work ethic and commitment to organization goals.

Also, would be able to:

· Plan own work activities

· Work as a member of a team

· Work without supervision

· work with minimum amount of supervision

· Work under pressure

· Work rapidly for long periods

CSR Experience

Call Center Experience

Data Entry Experience

Healthcare, Pharmacy, Hospital, Clinical

Thanks & Regards,

Mahesh Kumar | Team Recruitment | Mindlance, Inc. | W: 732-479-4523

maheshk(at)mindlance(dot)com