Responsible for conducting calls to Providers and Members (in English and Spanish) related to CMS measures, prescription Drug Prior Authorization (RxPA), and clinical program measures. Communicate with Providers and Member (English and Spanish) and provide information and assistance as appropriate. Responsible for handling Argus claims status inquiries, researching and facilitating resolution of issues; provider education on formulary concerns. Review and respond to interdepartmental tasks and coordinate the care of the member as necessary with the other departments such as Member Services, Health Ed, Care Management, Compliance, etc. Ensure the privacy and security of PHI (Protected Health Information) as outlined in policies and procedures relating to HIPAA compliance. About Aerotek: Aerotek, headquartered in Hanover, Md., is a leading provider of technical, professional and industrial staffing services. Established in 1983, Aerotek is an operating company of Allegis Group, the largest provider of staffing services in the U.S. Aerotek operates a network of more than 200 non-franchised offices throughout the U.S., Canada and Europe. For more information, visit aerotek.com. Aerotek is acting as an Employment Agency in relation to this vacancy. ()
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