About The Position
Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. Works with the pharmacy team in implementing policies to manage pharmacy benefits. The work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
Requirements
- High School Diploma or Equivalent (GED)
- Minimum of 2 years Customer Service experience
- Communication skills
- Customer Retentions skills
- Customer Service skills
- Customer Support Policies, Standards And Procedures skills
Nice To Haves
- Rotating Weekend and Holiday coverage
Responsibilities
- Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests.
- Works with the pharmacy team in implementing policies to manage pharmacy benefits.
- Maintains understanding of all policies and procedures related to the pharmacy benefit.
- Provides the highest level of customer service and support to members and physicians.
- Adheres to all regulatory standards.
- Works with Pharmacists to resolve clinical issues with providers in a timely manner.
- Documents accurately all inquiries and prior authorization requests according to departmental policy.
- Determines appropriateness of pharmacy benefits under corresponding lines of business.
- Contacts providers and members to communicate the details of service, requests additional information and resolves outstanding matters.
- Updates current pharmacy benefits and serves as a facilitator to team members.
Benefits
- Healthcare benefits for full time and part time positions from day one
- Vision insurance
- Dental insurance
- Benefits for domestic partners
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
