Supporting Medicare members and healthcare providers, the full-time salaried Medicare Operations Representative II will process coverage-related requests through phone and fax, ensuring compliance with Medicare guidelines in an onsite environment. Key Responsibilities Process prior authorizations, coverage determinations, and appeals received via phone or fax Conduct inbound and outbound calls to gather necessary information and document case activities across multiple systems Ensure timely completion of cases in accordance with CMS timelines and departmental quality standards Required Qualifications At least six months of customer service, healthcare, pharmacy, or call-center experience Verifiable high school diploma or GED Typing speed of at least 30 WPM Ability to navigate multiple Windows-based computer systems simultaneously Strong data-entry skills and attention to detail