Customer Service Representative Jobs

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.

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:

• Negotiate reconsideration of claim payment when claims are denied
• Follow-up on outstanding invoice payments
• 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
• Partner with Claims Adjustors to determine claim eligibility and claim status
• Verify date of payment from insurance carriers or employers
• Obtain authorization from insurance companies to process new transactions
• Validate receipt of claims or invoices to the carrier
• Enter and maintain accurate records in our information system
• Maintain up-to-date knowledge of state guidelines and company policies on claims

Qualifications

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

Benefits

We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. If you are a Colorado resident, you may request additional information about the compensation for this role by emailing: [email protected] for assistance. The Company is an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. The Company does 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. #MIT