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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates proficiency in healthcare terminology and customer service, with strong communication skills and the ability to manage multiple priorities in a fast-paced environment. Capable of accurately documenting interactions and utilizing various software applications for data entry and record management.
Highest-signal resume keywords
Call Center ExperienceHealthcare Terminology KnowledgeMicrosoft Office ProficiencyData Entry SkillsProblem-Solving Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data EntryMedical Claims ProcessingEligibility VerificationPrior Authorization CoordinationDocumentation Review
Soft Skills
Strong Communication SkillsAttention to DetailMultitasking AbilityCustomer Service OrientationTeam Collaboration
Tools & Technologies
Microsoft WindowsMicrosoft OfficeMultiple Software Applications
Industry Keywords
HealthcarePrescription Medication BenefitsMedical AdministrationCall Center OperationsPerformance-Driven Environment
About the role
Key responsibilities & impact- Answer inbound calls from members, physicians’ offices, and healthcare partners regarding prescription medication benefits and coverage
- Verify member eligibility and determine medication coverage under applicable healthcare plans
- Explain medication coverage options and prior authorization requirements
- Provide updates on prior authorization requests and coordinate with appropriate departments
- Review medication inquiries, documentation, and requests for additional information
- Contact healthcare providers to obtain necessary information and support timely resolution
- Accurately document interactions, update records, and enter information into multiple systems
- Deliver professional, compassionate, and accurate customer service while meeting quality and performance expectations
Requirements
What you’ll need- High school diploma or equivalent
- At least 6 months of call center experience
- At least 1 year of experience in healthcare, medical claims, or medical administration
- At least 1 year of recent continuous employment with a previous employer
- Working knowledge of medical and healthcare terminology
- Strong verbal and written communication skills
- Excellent computer navigation, keyboarding, and data entry skills
- Proficiency with Microsoft Windows and Microsoft Office, and ability to learn multiple software applications
- Strong problem-solving skills, attention to detail, and ability to multitask
- Ability to work independently while contributing to a collaborative team environment
- Ability to manage competing priorities in a fast-paced, performance-driven environment
- Availability to work an assigned schedule Monday–Friday within 7:00 AM–8:00 PM Central Time
- Full attendance during training and no planned time off during the first 90 days of employment
- Dedicated, secure workspace
- Reliable hardwired internet exceeding 25 Mbps download and 10 Mbps upload
- Ethernet connection; Wi-Fi and mobile hotspots are not permitted
- Candidate-provided monitor of at least 19 inches with VGA or HDMI connectivity and corresponding cable
- Candidate-provided USB wired mouse
- Candidate-provided Ethernet cable
- Comfort working in BHIVE with an active webcam providing a continuous profile view of the workspace
Benefits
Comp & perks- Weekly pay
- Paid training: two weeks of structured training followed by two weeks of supported, hands-on nesting
- Performance incentives of up to an additional $2.00 per hour during training and nesting
- 100% remote work from home in an eligible U.S. location
- Career development and experience in healthcare operations, pharmacy benefits, and coverage review
- Workstation (laptop, desktop, or USB boot device, as applicable) provided
- USB webcam provided
- 4-port USB hub provided
- USB wired headset with microphone provided