Pharmacy Help Desk Representative

Independent Health•Buffalo, NY

9d•$20

About The Position

The Pharmacy Help Desk Representative will be responsible for providing assistance to our pharmacies as well as internal servicing representatives in addressing and resolving pharmacy issues regarding reimbursement, proper utilization of policies and procedures and coordinating resolution to streamline the process through pharmacy education. These individuals must maintain our goals in achieving service levels and increasing the pharmacist satisfaction rate, the pharmacy help desk representative will function as a pharmacy advocate. This position will also assist with the entry of prior authorizations and other projects and assignments to support the pharmacy department. This position will assist with the training of new pharmacy help desk representatives and will act as a back up to member services phone lines. Occasional holidays, weekends, overtime, and on-call responsibilities are a requirement of the position.

Requirements

High School diploma or GED required; Associates degree preferred.
Six (6) months experience handling self-funded pharmacy calls or working for a health insurance company or physician’s office interacting with pharmacies; OR pharmacy tech certification required.
General knowledge of drug names, therapeutic categories, dosage forms, manufacturers, and packaging.
Excellent written and verbal communication skills and problem-solving skills required, including the capability to absorb new concepts.
PC and Windows experience required, including typing skills.
Familiarity with on-line claim systems preferred.
Demonstration of math aptitude for purposes of calculating simple drug requirements when given dosing and price calculations.
Proven examples of displaying the Pharmacy Benefit Dimensions (PBD) values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring.

Responsibilities

Customer Servicing Answer all types of provider phone calls and written correspondence in a timely fashion, with minimal supervision by a manager.
Ensure that providers are obtaining accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries.
All calls to be logged into call documentation systems.
Answer and document inquiries by internal customers including, but not limited to our servicing representatives and sales representatives.
Answer member services calls as needed and document appropriately.
Responsible for being logged in and ready to take calls at the start time of shift.
Exercise a courteous, efficient, respectful, and timely response to all internal and external customers.
Attend customer service training sessions and additional pharmacy system training as needed.
“On-call” responsibilities on a rotating basis.
In addition to assisting PBD departments with employee training, will assist with check and voucher questions and special projects as needed.
Maintain technical knowledge regarding Independent Health and PBD pharmacy contracts and benefits and working knowledge of policies and procedures and department lists; and maintain updates on a daily basis.
Assist in interpreting database information as it relates to pharmacy claims processing.
Assist with PBM implementation by identifying potential issues and entering prior authorizations to reduce/avoid disruption and ensure smooth transition for new PBM plans/members.
Assist the Pharmacy systems department with various data entry projects/information as they relate to pharmacy claims processing.
Provide accurate and up-to-date information to all pharmacy providers by documenting pertinent information into Siebel; assist other departments in responding to questions from any pharmacy department mailing.
Assist with preparation (triaging), logging in and logging out of authorization requests during evening and weekend shifts.
Assist authorization area of the pharmacy department during the day, if needed.