Get to learn about managed care, insurance pools, stars and service quality, presenting relevant information to members, partners, government officials, law firms, DME, PBMs, other third parties, interpreting and applying medical policies, understanding medical devices, pharmaceuticals, medical suppliers/DME, reading lots and lots of contracts, various authorizations, international coverage and moving bodily remains, authorizations, reasons for limiting IP stays, deliveries, ACA's provisions, abortions, self-insured plans, complaint handling, emergencies, medical errors, competing health systems, HIPAA, balance billing, system capacity issues and scheduling, current health condition trends and wellness programs, knowing and using medical terminology to communicate with experts, pharmacists, mental health specialists, and nurses, matching credentials with services and medical diagnoses provided, understanding financial accounts and how they work with health plans, accumulations, requesting daycare billing, how to operate these products, coordination of benefits, STEP Rx, anti-vaccine callers, transplants, genetic testing, FWA, experimental clinical trials, what to do with people who desperately need financial and/or health services right now, how to work with translators, advocate for members who don't understand what's happening, and much much more. Truly, much much much much more...
Company provides training for three months, and then expects you to apply this information to all the scenarios that you have never thought of or dreamed existed. Can be incredibly boring to incredibly intense in a matter of seconds. Every click of the mouse, breath in the mic, and button you press will be recorded to see how you react (not respond) in any and all scenarios. Common sense, use of "evidence" and expert advice before making decisions is necessary. Insanely high expectations for servicing members and broader community.
Nice members.
Knowing it's not just you. Most people struggle, and most people either find a new role outside the company or are let go within a few years. Your skills and educational background must closely match internal company roles. Otherwise, there is little to no career advancement.
Excellent match and health insurance.
If you do not have a degree, it's ok. There's a standardized test that you take before the interview round. The department recruits nationally, because they want the best. Some reps had graduate degrees and some reps had GEDs.
