15 ago
|
inmar
|
Guadalupe
This role is office-based in Mexico. The role requires professional fluency in English (spoken and written).
Under the minimal supervision of the PRCM Operations Supervisor or PRCM Operations Manager and through collaboration with fellow team members, the Conversion Representative facilitates resolving Unapplied Cash Category 1 (UAC Cat 1) through the conversion of paper remittance advice to electronic remittance advice, setting up secure transmission connections with carriers, and establishing working relationships with Pharmacy Benefit Managers and insurance carriers.
Major Responsibilities/Essential Functions:
Facilitate the conversion from paper remittance advice to electronic remittance advice. Electronic remittance conversion is key as it reduces manual efforts of managing paper remittance. (70%)
- Analyze client/carrier trends to identify conversion opportunities
- Create and maintain conversion tracking logs for all assigned clients
- Participates in Onboarding meetings with clients
- Responsible for weekly/monthly updates to the Conversion team metrics
Professionally communicate with Pharmacy Benefit Managers and Insurance Carriers to retrieve electronic remittance advices (15%):
- Establish a working relationship with the client’s Pharmacy Benefit Managers and Insurance Carriers.
- Understand the communications channels within the assigned Pharmacy Benefit Manager and Insurance Carriers
- Must be able to track requests for the conversion to electronic remittances.
- Consistently follow-up on electronic conversion requests with carriers
Collaborate with other teams key functional teams as necessary (10%):
- Proactively communicate any known issues to team members
- Escalate items as needed to manager for higher level distribution
- Prioritize conversion requests to meet the demands of a diverse client base
- Communicates with Client Service and Client Operations teams regarding conversion updates
- Communicates with EDI/NOC/SFTP centralization team for
📌 Representative, Payer Conversions (Guadalupe)
🏢 inmar
📍 Guadalupe