Appointment Setter, Healthcare Advocate and Home Warranty Authorizer

Advocate for a healthcare account based in US Discuss member with their coverage like other plan that we offer and different benefits stages of their plan Assist the member in making monthly payment for their Medicare Part D plan. Checking the medication’s tier, copays, restrictions, and alternatives Discuss the reason for the denials of their medication such refill too soon, requires prior authorization, exceeded to the quantity limit and DUR rejections Assisting member to file prior authorization and/or non formulary / excluded. Providing preferred pharmacies that is located near to their home Process vacation supplies and communicate with the pharmacies for overrides and processing member’s claims. Do test claims for the medication and provide estimated cost of the medication

Discuss member with their coverage like other plan that we offer and explain the contract that they have. Assist the member in making monthly payment and update the payment source Placing work order including setting appointment and find a technician that can provide service to fix the unit. Discuss the reason for the denials of some parts and the amount. Provide option if they refuse to pay the non-covered cost. Process expedited request and look for the technicians that can work with 24 hrs. Send emails and call the technicians to have update / diagnosis on the service. Do transfer vendor/technician if they can’t service with in time guidelines. If member would like to cancel, we try to save the member from cancelling the policy by educating the advantages of benefits and importance Call parts purchasing department to have update. Do follow up callback if needed. Back Office Experience Recieve call coming from pro and make decision base on the coverage og member Authorizing repairs base on coverage Order parts and make follow up to pro Do outbound call to informed member with non-covered cost Communicate Field manager via email for cost review of repair

Placing work order including setting appointment and find a technician that can provide service to fix the unit. Discuss the reason for the denials of some parts and the amount. Provide option if they refuse to pay the non-covered cost. Process expedited request and look for the technicians that can work with 24 hrs. Send emails and call the technicians to have update / diagnosis on the service.