Medicare Grievance Specialist (Pharma Technicians)
Gratitude IncMedicare Grievance Specialist (Pharma Technicians)
Job Description
Key Skills
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QUALIFICATIONS:
Education and Certifications:
• Medical Allied Health graduate required (licensed/non-licensed)
• Strong pharmacovigilance/ drug safety review experience (preferred but not required)
Experience:
• Minimum 1 year of experience in a healthcare contact setting work experience (e.g.,
pharmacy technician, claims processor, provider services)
• Experience handling grievances or healthcare-related customer support in a
contact center setting
Other Requirements:
• Understanding of HIPAA and other healthcare regulations.
• Willingness to work flexible schedules, including US hours and holidays
Recommended Minimum Skills Requirements (MSRs):
- Technical Skills:
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
- Soft Skills:
• Strong problem-solving and decision-making abilities
• Excellent verbal and written communication skills in English
• High level of empathy, patience, and active listening - Operational and Communication Skills:
• Ability to prioritize tasks and meet deadlines in a fast-paced environment
• Strong organizational and documentation skills
• Accuracy and attention to detail
• Ability to communicate effectively and convey complex information
KEY RESPONSIBILITIES:
- Grievance Handling:
o Investigate and resolve member grievances related to Medicare Part D drug
coverage, claims, and pharmacy issues
o Ensure all grievances are resolved within required CMS timelines and documented
appropriately - Communication:
o Act as a liaison between members, providers, and pharmacies for Medicare
grievance resolution
o Provide clear and empathetic communication throughout the grievance process - Compliance:
o Adhere to all CMS (Centers for Medicare & Medicaid Services) guidelines and
company policies
o Maintain confidentiality of sensitive member information - Documentation:
o Accurately document all interactions and resolutions in the client system
o Prepare reports as required for compliance and auditing purposes - Collaboration:
o Work closely with other departments to investigate and resolve grievances
o Provide insights and feedback on recurring issues to improve processes
Role
Medical Specialist
Timings
Night Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Functional Area
Medical Professional / Healthcare Practitioner / Technician
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
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