Pharmacy Services Specialist (Adecco)

Company Overview

The Enlyte Family of Businesses

Mitchell | Genex | Coventry

Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.

Job Description

We’re seeking several talented individuals to join the Pharmacy Solutions team. Our Pharmacy Services Specialist assist pharmacies, patients and insurance companies in prescription processing in accordance with established policies. Responsibilities include but are not limited to the following:

• Answer incoming calls to assist customers with a variety of inquiries
• Place calls to gather data to resolve pharmacy, insurance claim, and insurance coverage inquiries
• Obtain authorization from insurance companies to process new transactions
• Partner with Claims Adjustors to determine claim eligibility and claim status
• Verify date of payment from insurance carriers or employers
• Enter and maintain accurate records in our information system 
• Negotiate reconsideration of claim payment when claims are denied
• Validate receipt of claims or invoices to the carrier
• Follow-up on outstanding invoice payments
• Maintain up-to-date knowledge of state guidelines and company policies on claims

We are hiring based on experience anywhere from $13-$15/hr

Qualifications

• No previous industry experience is required as we provide comprehensive on-the-job training
• Minimum 2-4 years of related experience is required
• Basic computer and keyboarding skills are required; Microsoft Office suite is a plus
• Excellent interpersonal and communication skills, including good grammar and diction
• Maintain a positive and professional demeanor during all business interactions
• Ability to quickly and accurately organize and manage multiple priorities
• Ability to read and interpret documents such as operating/procedure manual
• Make sound decisions with an ability to learn quickly
• Understanding of medical terminology and billing is desired
• Ability to sit for long periods of time (up to 8 hours per day)  

Licenses or Certifications: Medical Coding certification is a plus

Written Abilities: Proficient grammar, sentence structure and written communication skills are required.

Education: Minimum High School diploma or GED equivalent required. Some training in medical billing would be a plus.

Mitchell International, an equal opportunity employer, values the diversity of our workforce and the knowledge of our people.  Mitchell will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.

Salary : $13 - $15