Eligibility Senior Representative

Role Overview

The Eligibility Senior Representative performs specialized patient access functions requiring an advanced understanding of insurance benefits and internal processes. They liaise with Payers, Pharma, Physicians, and Patients to reduce client abrasion and facilitate the timely processing of referrals.

What You Will Do

Facilitate cross-functional resolution of drug coverage issues, resolve basic patient claims issues, and prepare and review claims to ensure accuracy to payer requirements.

Why It Might Be a Fit

This role requires excellent phone presentation and communication skills, ability to handle professionally challenging customers, and adaptability in a dynamic work environment.

Requirements

• High school diploma or GED
• RxHome experience preferred
• At least 2+ years of related working experience
• Healthcare experience with medical insurance knowledge and terminology
• Intermediate data entry skills and working knowledge of Microsoft Office
• Excellent phone presentation and communication skills
• Demonstrated ability to handle professionally challenging customers
• Ability to adapt in a dynamic work environment and make decisions with minimal supervision

Benefits

• Medical
• Vision
• Dental
• Well-being and behavioral health programs
• 401(k)
• Company paid life insurance
• Tuition reimbursement
• Paid time off
• Paid holidays