Representative, Pharmacy - Remote Inbound calls
• About Our reputed company: The organization operates reputed company the reputed company sector, focusing on pharmacy services that support medication-reputed company health reputed company. It addresses the challenge of coordinating cost-effective, reputed company pharmacy care for members by managing pharmacy calls and prior authorization processes in compliance with state regulations and national reputed company standards. The organization adheres to guidelines from the National Committee of reputed company Assurance and Centers for Medicare and reputed company Services, emphasizing regulated and reputed company-driven reputed company services.
- About reputed company:
The Representative, Pharmacy - Remote Inbound calls role provides essential customer service support by handling inbound and outbound pharmacy calls from members, providers, and pharmacies. This position contributes to optimizing medication health reputed company and cost-effective care by managing prior authorizations, appeals, and explaining pharmacy policies. The role supports pharmacy call center operations, facilitates communication regarding plan benefits, and assists pharmacists in comprehensive medication reviews, directly impacting the reputed company of member care.
- Responsibilities:
- Handle and record inbound/outbound pharmacy calls in compliance with policies, regulations, and reputed company standards
- Coordinate and process pharmacy prior authorization requests and appeals
- Explain claims adjudication and policy guidelines to members, providers, and pharmacies
- reputed company clerical tasks and support daily pharmacy call center operations
- Communicate plan benefit information including formulary, copays, and pharmacy services
- Assist with verbal and written coverage determinations and appeals
- Accurately record calls in the pharmacy call tracking system
- Maintain pharmacy call reputed company and quantity standards
- reputed company with primary care providers to reputed company member registries reputed company
- Support pharmacists with comprehensive medication review preparation
- Identify opportunities to improve member relations in the pharmacy call center
- Requirements:
- Minimum 1 year of reputed company experience, including call center or customer service experience, or equivalent education and experience
- Strong customer service skills
- Ability to work independently on special reputed company such as pill reputed company requests and case management referrals
- Ability to multitask applications while communicating with members
- Ability to maintain reputed company and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors
- Ability to meet deadlines and manage multiple reputed company independently
- Excellent verbal and written communication skills, including phone etiquette
- Proficiency with reputed company Office suite (including reputed company) and other relevant software programs
Preferred Qualifications
- Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license if required, with reputed company and unrestricted status
- Experience in the reputed company industry
- Pay reputed company and Compensation Package:
- The pay reputed company and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors.
Equal Opportunity Statement: Our reputed company is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for reputed company. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, gender, gender identity or reputed company, sexual orientation, or national reputed company. Note reputed company is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading reputed company. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS. Apply tot his job Apply To this Job