Medical Call Center Representative

at Pomeroy
Location Charlotte
Date Posted November 25, 2021
Category Call Centre / CustomerService
Job Type Not Specified


**Remote for now, but must be located within commutable distance to Charlotte**

**Must be Vaccinated**


  • Determination of patient insurance eligibility through electronic submission or manual phone call; contact insurance company to verify insurance eligibility and benefits structure in accordance with Medco's standard operating procedures
  • Identification of need for, submitting of, and obtaining of required Insurance Payor Prior Authorizations for treatment, including preparation and submission of payor specific authorization forms and medical necessity documentation. Monitoring of Prior Authorization time periods, queuing of expiring Prior Authorizations for action to obtain Prior Auth renewals
  • Review/data entry of insurance payor eligibility, benefits responses, and Prior Auth information including setting up of appropriate payor codes in the applicable Medco operating systems.


  • Must posses a high school diploma and 6-18 months work experience in a customer service or call center environment.
  • Excellent written and oral communication skills
  • Proficiency with computers & good typing skills
  • Detail oriented with a focus on accuracy
  • Ability to multi task
  • Handle data effectively
  • Ability to meet deadlines
  • Resilience & Flexibility coupled with Drive & Persistence
  • Learning and knowledge enhancement
  • Ability to work under pressure situations
  • Interpersonal Skills and Teamwork
  • Willing to work in shifts
  • Should have healthcare domain basis knowledge
  • Patient/Payor Authorization knowledge/experience will be preferred 15


- provided by Dice

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