Customer Service Representative

About the role

Elusa Health is seeking a Customer Service Representative to support medical benefit verification and pharmacy claim processing. The role involves interacting with healthcare providers, insurance companies, and internal systems to ensure accurate patient benefit information.

Key responsibilities

• Handle benefit request investigations submitted by MD offices via phone or web portal.
• Contact insurance companies to obtain specialty pharmacy and prescription benefits.
• Update pharmacy claim processing details (BIN, PCN, ID, Group numbers) in the IPS system.
• Document notes on patient profiles regarding pharmacy benefits and resolve errors in the IPS error queue.
• Manage complaints, process claims, and follow up on authorizations.
• Produce weekly call/disposition reports and ensure compliance with ISO 27001 and 9001 security policies.

Required profile

• Strong communication skills and ability to work in a fast‑paced environment.
• Critical thinking, time management, and problem‑solving abilities.
• Professional composure and attention to detail.

Required skills

• Experience with insurance verification and pharmacy claim processing.
• Familiarity with IPS or similar healthcare information systems.

What we offer

• Health insurance, provident fund, medical and casual leaves.
• Annual leaves, on‑job training, and annual increment.
• Loan facility, employee appreciation programs, and two days off per week.