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Pharmacy Call Center Tech

Full-time

Company Description

vTech can help you avoid the daunting task of writing and posting job offers, shifting through resumes and laboring through the lengthy interview process. Our Staffing solutions will allow you to elude those tasks and place topnotch, high-caliber professionals in the position you need to fill. We use our expertise, knowledge, and global resources to deliver top-quality candidates and tailor our IT and Non-IT recruitment services to your needs.

This allows us to deliver the required results in a timely manner that meets your schedule at a substantially reduced cost. We pride ourselves for having one of the fastest growth rate and also the lowest turnover rates in the industry just 2.5 percent annually. We focus on the training and retaining qualified professionals with high personal and work ethics. With the help of our extensive database of internal candidates and CATS applicants tracking system, we can provide quality resources within the limited time frame.

We have also successfully placed hundreds of candidates in the areas related to Information Technology, Engineering, professional, Scientific & Clinical, etc. for both our commercial and government clients.

• Source: A recruiter sources candidates from various sources; the search starts from our proprietary database. Using advanced sourcing methods like social media, professional networking media, internal, and 3rd party job boards, we identify qualified candidates.
• Validate: A recruiter validates the candidates' experience and skill sets against our client's position.
• Initial Screening: Based on the position and the client's work culture, the recruiter uses initial screening questions to determine the most suitable candidates.
• Submit: the recruiter will submit to the technical team qualified candidates who have passed the initial screening.
• Technical Screening: The technical team then prepares a matrix of the particular requirements and required experience for the position and using a list of questions and the results, re-validates the candidates' technical skills.
• Background Check: Administrative personnel will provide a detailed background check, as required, per client agreement.
• On board: On successfully completing the above steps, the candidates are welcomed on board and assisted to ensure a smooth integration at the client's location.

Job Description

Description:

Under the direct supervision of the Supervisor, Pharmacy Services Call Center, the Pharmacy Call Center Technician is responsible for providing knowledgeable and courteous customer assistance and response to members, providers and Pharmacy Call Center Technician inquiries. Principal Accountabilities: Handles calls and correspondence regarding pharmacy issues from providers/physicians and members. Identifies and/or responds to inquiries, benefit payments, complaints, dissatisfactions, grievances and claim issues.

Document calls in inquiry tracking system. Using established protocols ensures resolutions provided are presented in a clear and accurate manner. Facilitates problem resolution and acts as customer's advocate. Reviews daily work activity report to self-monitor performance and productivity standards. Identifies deficiencies/problems and adjust behavior and work activities as appropriate. Follows internal process and procedures to ensure activities are handled in accordance with departmental and company policies/procedures.

Performs initial research of pharmacy issues. Reconciles plan information utilizing department-generated procedures and reference materials. Appropriately escalates claims outside knowledge and/or clinical scope to higher-level call center staff or pharmacist for review. Utilizes internal Pharmacy systems to update, modify and extract member information. Assists network pharmacist in processing prescription claims. Reviews claims for accuracy and adherence to contract guidelines.

Reviews and authorizes appropriate faxed medication requests from institutional/long term facilities and maintains consistent contact with all facilities to assure KMHP protocols are maintained. Assists with entering prior authorizations when required; provides follow up assistance for prior authorization requests, follow up with request from physicians for denial letters, provides assistance in gathering historical claim information as required.

Provides Level II Pharmacy Technician, Supervisor and/or Pharmacist with background data needed for claim review, appeals and grievances. Discriminates between routine and significant matters; apprises management of issues which can negatively affect service and business. Identifies provider/physician/member issues and refers to appropriate departments. Suspend inquiries forwarded to pharmacists or other departments and follows through to ensure timely resolution.

Maintains a balance of productivity, quality and timeliness of job accountabilities. Participates in department self-audits procedures for on-going evaluation of services. Identifies and defines problems and opportunities within work area and attempts to resolve through appropriate channels. Demonstrates flexibility and cooperation when faced with changing priorities to meet shifting needs.

Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with KMHP employees and clients at all times. Adheres to KMHP policies and procedures; supports and carries out the Mercy Mission and Values. Demonstrates and supports commitment to corporate goals and mission. Performs other related duties and projects as assigned. Assist with training of new hires. Attends required training as requested. Develop and maintain desktop procedures.

Position Qualifications/Requirements: Education and Training: High School diploma or the equivalent Experience: 2 years Pharmacy Technician experience in a healthcare, long term care or retail environment. Licenses, Registrations or Certifications: National Pharmacy Technician Certification.

Additional Information

All your information will be kept confidential according to EEO guidelines.