Note: The job is a remote job and is open to candidates in USA. NTT DATA provides IT and business services, including healthcare and business process outsourcing solutions. The Medicare Services Representative II supports Medicare members, prescribers, and providers by processing coverage-related requests through phone and fax channels, ensuring accurate documentation and timely resolution in accordance with Medicare guidelines, CMS timelines, and internal quality standards.
Responsibilities
- As a Rep II, Operations, you will support Medicare members, prescribers, and providers by processing coverage-related requests across both phone and fax (offline) channels
- In this role, you will be responsible for accurate case setup, review, outreach, documentation, and timely resolution of requests in accordance with Medicare guidelines, CMS-mandated timelines, and internal quality standards
- Regular and predictable attendance
- Ability to work mandatory overtime or extended workweeks when required
- Ability to sit for extended periods at a computer workstation
- Ability to type and use a mouse throughout the duration of the shift
Skills
- Minimum of 6+ months customer service, healthcare, pharmacy, call center, or related experience
- Flexibility to work shifts between 7:00am – 8:00pm CST (Monday–Friday) and rotating weekend or holiday coverage as required by business needs
- Dedicated, secure, and quiet home workspace required
- Reliable high-speed internet with ability to hard-wire into company equipment (**NO**wireless connection, **NO**hotspots)
- Regular and predictable attendance
- Ability to work mandatory overtime or extended workweeks when required
- Ability to sit for extended periods at a computer workstation
- Ability to type and use a mouse throughout the duration of the shift
- Call center experience
- Experience in a PBM, managed care, or healthcare environment
- Experience handling confidential patient or member information
- Familiarity with multi-system workflows (e.g., claims platforms, case management systems, internal databases)
- Pharmacy Technician Certification (CPhT) or related education
Benefits
- Remote, work-from-home position.
- Medical, dental, and vision insurance may be included, depending on the nature of the role offered.
- Flexible spending or health savings account may be included, depending on the nature of the role offered.
- Life and AD&D insurance may be included, depending on the nature of the role offered.
- Short- and long-term disability coverage may be included, depending on the nature of the role offered.
- Paid time off may be included, depending on the nature of the role offered.
- Employee assistance may be included, depending on the nature of the role offered.
- Participation in a 401k program with company match may be included, depending on the nature of the role offered.
- Additional voluntary or legally required benefits may be included, depending on the nature of the role offered.
Company Overview
Company H1B Sponsorship