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Express Scripts Eligibility Analyst - Operations in St. Louis, Missouri

POSITION SUMMARY

  • This position provides business support to clients and account management to ensure satisfaction with issue resolution.
  • Consults with Account Management, leadership and other ESI areas to provide analysis and direction on prioritizing and resolving client issues, with minimal client interaction.
  • Responsible for handling daily routine issue analysis, work assignments and other administrative support.
  • May facilitate activities with other areas to oversee delivery of client’s needs.
  • Participates in process improvement activates and share ideas for enhancing processes.

ESSENTIAL FUNCTIONS

  • With a focus on quality and timeliness, maintain ownership for assigned work queue.
  • Meet all service standards to ensure client satisfaction
  • Handle routine work stream assignments along with, but not limited to, member and file research, assisting with file processing, advisory role to account mgmt.

  • Resolve issues and provide escalation as needed

  • Participate in process improvement conversations and implementation
  • Provide support for year end and 1/1 readiness activities outside of normal schedule
  • Participate in weekly team meetings

QUALIFICATIONS

  • [CERTIFICATION or EXPERIENCE]
  • Strong PC skills including Microsoft Office products, e-mail and internet
  • Excellent verbal and written communication and presentation skills highly desirable
  • Strong attention to detail; problem solving and analytical skills preferred
  • Knowledge of the health care and PBM industry and its products and services
  • Ability to work cross functionally to resolve client issues.
  • Willingness to implement fast pace change and manage to tight timelines
  • 1 to 2 years previous experience in data management, database administration, or applicable technical certifications.
  • 2 to 3 years previous experience in customer service, focus on client engagement preferred.

ABOUT THE DEPARTMENT

The mission of PBM Services is to meet market needs for speed, flexibility and reliability, while driving and influencing best operational practices. PBM Services includes Client and Benefit Administration, Manual Claims Processing, Eligibility, Quality Control, Implementation and the Client Service Center. These centralized functions support the client lifecycle throughout the enterprise, helping to “get it right the first time” and thereby increasing client satisfaction and reducing waste and the cost of rework.

ABOUT EXPRESS SCRIPTS

At Express Scripts, we dare to imagine a better health care system, and we’re driven to make it happen. Where some see obstacles, we see possibilities. We’re challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all.

We have always acted first to take on the toughest challenges. We uniquely partner across the health care ecosystem to uncover opportunities, take action, advance health care and deliver better outcomes – like no one else can. We believe health care can do more. We are Champions For BetterSM.

Express Scripts, part of Cigna Corporation, unlocks new value in pharmacy, medical and beyond to further total health for all.

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