Call Center Agent for a Pharmaceutical account
(National Capital Reg – Mandaluyong)

* Processes phone and fax authorization requests for medical services from physicians and hospitals in an efficient, accurate and customer-focused manner.

* Essential Functions:
* Effectively handles authorization requests and inquiry phone calls from providers, balancing excellent customer service with efficiency
* Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status
* Based on the information provided by the provider, and gathered from computer systems, determines the appropriate handling of each inpatient or outpatient request
* Utilizes online tools to determine authorization requirements based on the type of service requested, the location of the service and the provider specifics
* Accurately enters authorization requests into the Healthcare system
* Based on the authorization rules and urgency of the request, either approves the authorization request or escalates to a nurse for review
* Communicates authorization specific to providers either verbally on the phone calls or written through fax

REQUIREMENTS:

* Education/Experience:
* Degree in Pharmacy of Pharmocology
* Knowledge of medical terminology and/or experience with CPT and ICD-9 coding strongly preferred
* Minimum of 1 year of customer service experience
* Call Center experience a plus

* Computer Skills:
* Ability to manage multiple computer programs to process a single request
* Proficient in data entry
* Knowledge of Sidewinder and Peradigm systems a plus
* Knowledge in Microsoft Office including Outlook, Word and Excel

* Other Skills:
* Ability to understand and follow detailed procedures and authorization rules
* Ability to communicate effectively, both orally and written
* Ability to multi-task
* Ability to take ownership of an issue and problem solve effectively
* Ability to work as a team with other internal and vendor groups
* Demonstrates a positive attitude on a daily basis during potential stressful situations involving internal and external customers, as well as system and/or process problems
* Demonstrates the ability to visualize, listen, and probe for opportunities for improvement, while maintaining a positive outlook of the company.
* Exhibits exceptional problem solving and time management skills
* Applicants should be Filipino citizens or hold relevant residence status.

Company Name :
Teleperformance
Industry :
Call Center / IT-Enabled Services / BPO
Type of Company :
Private Limited Company, Foreign Based Company
Location :
Pavillon Mall EDSA Central Mandaluyong City —-
Company Fax :
(02) 637-7111 loc. 323
WebSite :

http://www.teleperformance.ph