Client Service Representative I

*Call Center Environment *Remote US *Hours: Assigned shifts vary from 7AM-8PM CT. *6-8 weeks of mandatory Training hours 8AM-430PM CT

Position Summary: The Rep I, Clinical Services takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.

The Rep I, Clinical Services will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

Duties:

• Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.
• Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
• Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).
• Identify and elevate clinical inquiries to the pharmacist team as appropriate.

Minimum Qualifications: 6 months -3 years in a customer service or call center environment managing 75 calls/day. Computer experience is required with proficiency in Microsoft Outlook, Word and Excel. Knowledge or prior authorization process

Preferred Qualifications: * * Experience in a health care setting or insurance industry is a plus, including knowledge of basic insurance and third party terms and medical terminology. *Must have effective and empathetic communication style in managing inbound calls and communications with clients and team members. * Basic alpha number data entry skills with attention to accuracy and quality is essential. * Intermediate math skills are required with attention to detail and quality essential. * Ability to work with people in a team environment while meeting individual performance goals. * Must be able to read and interpret policies, procedures and instructions. * Effective organizational skills and ability to prioritize a fluctuating workload and competing priorities is essential.

Education: High School Diploma or GED required. Associates degree in Business, Accounting or equivalent work experience preferred.

About NTT Data Services:

NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.

NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is 17.75 hr. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. #INDHRS