Customer Service - Pharmacy Technical Support Specialist 105-1073

Community Care • Tulsa, OK

13d

About The Position

Responsible for providing technical and customer service support for pharmacy benefits, processing prior authorizations according to CMS and State regulations, and resolving pharmacy related complaints. This role involves telephone support for pharmacies and members regarding pharmacy benefits for the HMO product, resolving claims adjudication issues, and processing prior authorizations for medications. The position may require overtime to meet deadlines and may involve dealing with disgruntled or upset members.

Requirements

• Basic punctuation and grammar skills
• Ability to function under pressure
• Proficient in Microsoft applications
• Ability to work independently and apply good judgment
• Ability to maintain and preserve information of highly confidential nature
• Strong oral and written communication skills
• Capable of project management from beginning to completion
• Successful completion of Health Care Sanctions background check
• High school diploma or equivalent
• Two years’ experience in managed care pharmacy benefits, pharmacy tech or related discipline
• Basic understanding of Health Plan Industry
• One year customer service experience required

Nice To Haves

• Previous customer service experience in a Medicare Advantage plan preferred

Responsibilities

• Provide telephone support for pharmacies and members related to pharmacy benefits for the HMO product.
• Provide resolution for various types of phone calls including, but not limited to referral, authorization, and step therapy protocols between physicians, pharmacies and members for the HMO product.
• Resolve claims adjudication issues related to pharmacy.
• Process prior authorizations for medications.
• Perform other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED