Note: The job is a remote job and is open to candidates in USA. NTT DATA is a provider of IT and business services, including healthcare and business process 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
- Support Medicare members, prescribers, and providers by processing coverage-related requests across both phone and fax (offline) channels
- Accurate case setup, review, outreach, documentation, and timely resolution of requests in accordance with Medicare guidelines, CMS-mandated timelines, and internal quality standards
- Work will be performed through a combination of inbound and outbound phone interactions and fax-based casework
- 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
- Flexibility to work shifts between 7:00am - 8:00pm CST (Monday-Friday) and rotating weekend or holiday coverage as required by business needs
- Overtime and extended hours may be required during peak periods
- Remote, work-from-home position
- 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
- Minimum of 6+ months customer service, healthcare, pharmacy, call center, or related experience
- 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
- Flexible spending or health savings account
- Life and AD&D insurance
- Short- and long-term disability coverage
- Paid time off
- Employee assistance
- Participation in a 401k program with company match
- Additional voluntary or legally required benefits
Company Overview
Company H1B Sponsorship