TEMP BPO Senior Representative

Job Summary

• The Intake I (IQA) Associate takes in-bound calls from members, providers, etc. providing professional phone assistance to all callers through the criteria based prior authorization process.
• Maintains complete, timely and accurate documentation of all requests, and transfers all clinical questions and judgement calls to the nurse or pharmacist.
• The Intake I (IQA) Associate will also assist with other duties such as outbound calls, monitoring/responding to inquiries in mailboxes and other duties as assigned by the leadership team.

In this role, you will be responsible for:
• Training and working virtually- Working independently but be self-aware enough to know when to ask for help
• Utilizing multiple software systems
• Meeting or exceeding government mandated timelines
• Complying with turnaround time, productivity and quality standards
• Conveying resolution to beneficiary or provider via direct communication and professional correspondence
• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance
• Be technically capable to understand trouble-shooting steps and be able to communicate the results to leaders or IT
• Ability to effectively communicate verbally with members and prescribers while managing multiple software systems
• Critical thinker/problem solver
• Ability to execute successfully in a deadline-oriented, fast-paced, highly-regulated environment
• Proficient in navigation of multiple computer applications
• Proficient use of keyboard, mouse and ability to navigate 2 workstation monitors