Specialty Operations Pharmacy Technician

CenterWell • Work at Home - Ohio, OH

1d • $40,000 - $52,300 • Remote

About The Position

The Specialty Operations Pharmacy Technician 2 supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications. The Specialty Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Requirements

• Must have an active license with the Board of Pharmacy in the appropriate state
• Must be PTCB certified
• 1+ year of claims processing, insurance or pharmacy experience
• Must have strong MS Office skills as this role is report heavy
• Self-provided internet service must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Inbound/Outbound call experience
• Customer service experience
• Strong communication skills

Responsibilities

• Supports Pharmacists in Specialty Rx medication preparation by dispensing Specialty Rx medications.
• Performs varied activities and moderately complex administrative/operational/customer support assignments.
• Performs computations.
• Analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial.
• Adjudicates pharmacy claims and process pharmacy claims for payment.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed