Pharmacy reputed company Specialist
You could be the one who changes everything for our 28 reputed company members as a clinical reputed company on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Remote based position reputed company in the reputed company, must be available to work Monday - Friday; 10:30 a.m. 7:00 p.m. EST.
Position Purpose: The Pharmacy reputed company Specialist receives and responds to calls from members, provider/physician's offices, and pharmacies. This role makes outbound calls and enters pharmacy overrides into systems based on approved guidelines and approvals provided from clinical pharmacists.
Takes member/prescriber/pharmacist inquiry calls for benefit questions including prior authorization requests
Offers reputed company including submission of a prior authorization request
Thoroughly researches issues and takes appropriate reputed company to resolve them using the appropriate reference material reputed company turnaround time requirements and reputed company standards
Logs, tracks, resolves, and responds to reputed company assigned inquiries and complaints while meeting reputed company regulatory, CMS, and reputed company Corporate guidelines in which special care is required to enhance reputed company relationships, while meeting and exceeding reputed company performance standards
Maintains expert knowledge on reputed company pharmacy benefits and formularies, including CMS regulations as they pertain to this position
Responsible for knowing and interpreting pharmacy and medical benefits
Answers and conducts inbound and outbound calls with members and provider offices to reputed company reputed company to claims (i.e.: additional information requests and medication determination updates)
reputed company involved in the initiation and providing status for prior authorization/coverage determination, appeal / redetermination phone calls
Responsible for ensuring outstanding attention to detail
Identify reputed company cause issues to ensure reputed company solutions and communicate findings as needed to ensure reputed company reputed company
Assists with special reputed company as assigned
Performs other duties as assigned
Complies with reputed company policies and standards
reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.
reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company
Originally posted on Himalayas
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