Associate Rx Customer Service Specialist

Abarca Health • Remote, FL

11h • Hybrid

About The Position

Abarca is revolutionizing healthcare by redefining pharmacy benefits through smarter technology. The PBM Operations & Services team is central to Abarca's mission, managing services such as MTM, price eligibility, configurations, and beneficiary services. The Rx Customer Service team is at the forefront, conducting satisfaction surveys, resolving complaints, processing manual reversal requests, and addressing other needs for beneficiaries, pharmacies, and clients. As an Associate Rx Customer Service Specialist, you will be the primary point of contact for all communications (calls, emails, and faxes) with pharmacies, beneficiaries, and prescribers. You will utilize the Rx Platform and other resources to effectively resolve caller inquiries and issues.

Requirements

• 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting.
• Excellent oral and written communication skills in English.
• This position requires availability to work in a specified time zone, accommodating the business needs of our clients and tea m members based in the in the determined time zone.

Nice To Haves

• Active Pharmacy Technician License.
• Bilingual fluency in Spanish in oral and written communication skills.
• Experience in PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and / or healthcare.

Responsibilities

• Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers.
• Provide service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to answer should be less than 30 seconds.
• Provide rejection support, including overrides.
• Provide Coverage Determination status to clients including exceptions and appeals.
• Document PA request inquiries, issues, status, and resolution in accordance with federal and department and company policies and guidelines.
• Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support and response to price appeals.
• Report identified issues to the appropriate department, for investigation and correction, following the established procedure.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree