• Respond to patient inquiries via a ticketing system with clear, accurate, and empathetic written communication • Manage inbound calls and make outbound calls to patients to address queries, concerns, and offer support • Maintain accurate documentation of all patient interactions • Collaborate with internal teams across time zones • Deliver a high standard of patient care while adhering to regulatory and compliance requirements

• Respond to patient inquiries via a ticketing system with clear, accurate, and empathetic written communication • Manage inbound calls and make outbound calls to patients to address queries, concerns, and offer support • Maintain accurate documentation of all patient interactions • Collaborate with internal teams across time zones • Deliver a high standard of patient care while adhering to regulatory and compliance requirements

Assist in formulary management by overseeing prior authorization processes and utilization review reporting. Communicate effectively with healthcare professionals and prepare necessary documentation while administering appeals and grievances.

• Responds to telephone inquiries from providers on subscriber verification, benefit eligibility, plan maximums, requirement of prior approvals and claim inquiries • Verifies claims through online adjudication systems • Makes suggestions for ways of improving workflows and processes • Records and forwards provider feedback to the appropriate Team Manager and/or Manager • Supports various projects and analyses using Excel, Word, and other computer software • Logs details of calls • Assists with other duties as required