Senior Associate, RX Specialist

Ametros • Wilmington, MA

5d

About The Position

Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds. Ametros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Our flagship product is revolutionizing the way funds from insurance claim settlements are administered after settlement. Ametros continues to innovate, bringing new solutions to the market with the goal of simplifying healthcare for our clients. We make managing medical funds safe, effortless, and cost effective for everyone. The Rx Specialist is primarily responsible for providing customer service on all pharmacy related services. The Rx Specialist is primarily responsible for providing customer service on all pharmacy related services.

Requirements

• Weekend availability required for occasional (1-2 per month) Saturday/Sunday coverage rotation.
• Proficient with prescription terminology and authorization practices.
• Knowledge of healthcare information systems, Rx products and pharmacy services.
• Previous experience in pharmacy retail, medical, or customer service setting.
• Previous experience as a Pharmacy technician.
• Telephone etiquette.
• Excellent customer service skills.
• Strong analytical and problem-solving skills.
• Thorough understanding and proficient use of customer service best practices and techniques in the Pharmacy Benefit industry.
• Working knowledge of healthcare information systems and knowledge of Rx products and pharmacy services.
• Strong conflict management and customer service skills.
• Strong interpersonal and communication skills.
• Client management and relationship building.
• Ability to foster a positive and productive work environment.
• Ability to work in a dynamic fast paced atmosphere.
• H.S. Diploma or General Education Degree (GED) required
• 3-4 years experience in a pharmacy setting, ideally a call center pharmacy setting required
• Experience with prescription terminology and authorization practices required
• Experience with computer systems required, including some Microsoft application which may include Outlook, Work, Excel, PowerPoint or Access required

Nice To Haves

• National Certification from an accredited pharmacy technician certification program preferred

Responsibilities

• Responsible for answering inbound calls and assisting members with pharmacy related services.
• Contacting members to obtain any required pharmacy related information.
• Monitor and resolve all pharmacy rejected claims within the established turnaround times and in compliance with Medicare and regulatory requirements.
• Follow-up on authorization requests in a timely fashion.
• Contact members to obtain necessary approval on rejected pharmacy claims.
• Contact PBM as needed to resolve any complex pharmacy issues.
• Document all communication, upload appropriate documents to internal database, and document clear concise notes in our database to ensure accounts are up to date.
• Proactively identify issues, and work toward resolution.
• Act in compliance with security and HIPAA policies and procedures.

What This Job Offers

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