**Overview**

**Scope of Responsibilities:** Works under general supervision. Follows standard procedures to accomplish assigned tasks. May assist in orienting and training employees

**Job Summary:** Responsible for all aspects related to adjudication and billing of specialty prescriptions in a call center environment.

**Responsibilities**

**Job Duties:**

+ Responsible for monitoring adjudication queue(s)
+ Responsible for contacting members and prescribers on non-covered items
+ Facilitate prior authorization process for customers
+ Provide clinical services in TherigySTM
+ Customer service coverage for incoming calls and directing incoming calls
+ Provides resolution to customer service issues to ensure member satisfaction
+ Work with members to provide resolution to payment related issues on accounts/orders
+ Maintain and keep reasonable production as determined by supervisor
+ May assist in orienting and training...