• Submit and manage prior authorization requests for medications only, as required by insurance carriers. • Review physician medication orders, supporting clinical notes, and documentation to ensure prior authorization requests are complete and accurate. • Track medication prior authorizations from submission through approval, denial, or request for additional information. • Follow up with payers to ensure timely determinations and minimize delays in medication access. • Coordinate prescription refills in collaboration with providers and pharmacies. • Serve as the primary point of contact for pharmacies regarding medication-related questions, clarifications, and insurance requirements. • Support enrollment and coordination of patient assistance programs for medications when applicable. • Communicate with patients regarding medication-specific authorization requirements, timelines, approvals, denials, and next steps. • Identify medication prior authorization denials and coordinate appeals when appropriate. • Manage assigned work queues, tasks, and follow-ups to meet defined turnaround times. • Maintain compliance with payer requirements, HIPAA, and organizational policies.

• Responsible for performing all tasks relative to in-house and external communications with TrueScripts members, doctor’s offices’ and pharmacies • Responds to member and client inquiries • Assists members with appropriate prescription benefits • Problem solves any issues in claims system • Provides administrative support to Member Care Leadership, Client Success & Executive teams

Title: Manpower Temporary Member Service Associate Location: Remote United States Department: Member Services Job Description: If you are a personable, customer-service oriented individual and are interested in helping people understand the complexities of health insurance looking for a seasonal opportunity with the possibility of transitioning to permanent full-time we want to hear from you! Community Health Options is a non-profit, Member-led health insurance plan providing comprehensive health insurance benefits to individuals, families, and businesses. Our team of Member Services Associates (MSA) is responsible for assisting Community Health Options Members by responding to phone, mail, and/or email inquiries accurately and resolving issues in a consistent manner through an efficient, empathetic, positive and customer-focused approach. The MSA facilitates comprehensive first call resolution for our Members through a commitment to exceptional customer service, superior product knowledge and by effectively partnering with internal and external business partners. The MSA acts as a knowledgeable and empathic Member advocate providing navigational support for Community Health Options health insurance processes and online web systems. Additionally, the Member Services Associate supports health care providers, insurance agents and brokers using a similar customer-focused model. The MSA fosters and maintains close working relationships with all clients and takes a proactive, problem-solving approach to meet their needs. QUALIFICATIONS - Strong commitment to high level customer service. - Previous experience working with health insurance or a health care environment is preferred - One-year practical work experience in a call center or equivalent customer service environment - High school diploma, general education degree or equivalent - Able to analyze and interpret verbal and written instructions - Ability to effectively present information in a clear and concise manner - Ability to type quickly, efficiently, and accurately - Ability to multi-task using multiple computer systems and screens with strong organizational and time management skills - Ability to incorporate feedback to further professional development - Must be able to work in a fast-paced environment and adapt to change - Strong verbal and written communication skills - Ability to work as part of a goal-oriented team - Knowledge of Microsoft Office products Fulltime Seasonal Positions will start in the middle of July with a multiweek education program followed by a 6-month assignment. This is a remote position that requires a private and quiet workspace and a high-speed internet connection where Community Health Options will provide the required equipment. Convenient eight-hour shifts are available between 8AM 5PM Monday through Friday with weekends and major holidays off. A seasonal hourly rate of $18.00 per hour and up to a $1,000 completion bonus is available! - Potential for permanent full-time opportunities available upon completion of seasonal assignment for those that qualify and are interested in being part of the Community Health Options Team! SUPERVISED BY Member Services Manager

• Ensure process efficiency – Communicate with patients to coordinate fertility plans and medications. • Own the patient experience through resolving customer issues and ensuring 100% follow-up to customers while delivering an excellent customer service experience to all patients. • Pay attention to detail – Accurately obtain and enter patient information, including shipping, insurance, and payment details. • Be a team player – Escalate complex claims to the appropriate team for further action. • Accurately perform data entry tasks and enter prescriptions into our system. • Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately process prescription claims so they will be dispensed accurately. • Juggle multiple tasks without sacrificing attention to detail. • Participate in special projects and perform other duties as it pertains to specific contract performance. • Maintain required quality performance standards by delivering excellent customer service, adhering to phone and break schedules, and following established call handling guidelines.