Eligibility Lead Representative

HireTalent
  • St Louis, MO
  • Instant Apply
8 days ago

Job Description

***Must be able to work any shift between 7am to 8pm CST, Monday-Friday***
Training Start 12/07/2026 through 1/08/2027 from 8-5 pm M-F
1/11 released to production to individual supervisor and given operational scheduleDuties:
 ***Must be able to work any shift between 7am to 8pm CST, Monday-Friday***


 Accredo, a specialty pharmacy line of business within The *** Group, is hiring several Eligibility Lead Representatives. For this demanding customer centric role, you'll ensure our patients receive prescription insurance coverage for their medication. You'll handle continuous inbound and outbound calls, navigating multiple technical systems and platforms while gathering information from insurers, doctors, and patients to secure coverage. Your persistence and continuous follow-up will ensure our patients receive this vital medication in a timely manner.

 What You'll Do:


  • Use your knowledge of the healthcare industry, Prescription Benefit Programs, pharmacy coverage, Reimbursement and Insurance processes to ensure patients get their specialty medication

  • Manage constant inbound and outbound calls exemplifying the highest customer service standards to meet quality and production metrics

  • Use your advanced technical skills to navigate through multiple systems, applications, platforms and screens simultaneously all while speaking on the phone

  • Use your independent judgement in managing escalated patient or client complaints and discretion to escalate further if needed

  • Able to work any shift between 7am to 8pm CST, Monday-Friday - Required




Skills:

  • 1+ years of customer service experience Required

  • 2+ years of experience with Prescription Benefit Programs, Pharmacy Coverage, Prior Authorization, Eligibility or Insurance processes, Preferred

  • 2+ years of experience in healthcare, medical terminology, CPT and ICD codes - Preferred

  • Proficiency with Microsoft Office products (Word, Outlook, Excel) and technical savvy navigating multiple systems and platforms Required

Numbers & Facts

LocationSt Louis, MO

Skills

  • Compensation and Benefitsunmatched
  • Current Procedural Terminology (CPT)unmatched
  • Customer Escalationsunmatched
  • Customer Support/Serviceunmatched
  • Data Collectionunmatched
  • Healthcareunmatched
  • Insuranceunmatched
  • International Classification of Diseases (ICD)unmatched
  • Medical Terminologyunmatched
  • Medicationsunmatched
  • Microsoft Excelunmatched
  • Microsoft Officeunmatched
  • Microsoft Outlookunmatched
  • Microsoft Product Familyunmatched
  • Microsoft Wordunmatched
  • Multiplatform/Cross-Platformunmatched
  • Operations Managementunmatched
  • Pharmacyunmatched
  • Prescription Drugsunmatched
  • Quality Metricsunmatched
  • Time Managementunmatched

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