Large managed care company looking to fill contract to hire positions for the right candidates.
PHARMACY TECHNICIAN CANDIDATE PROFILE:
1. Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Outbound calls are made primarily using an autodialer requiring precision to detail and adaptability to type of response needed.
2. May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary.
3. Follows system scripting and validates member demographic information.
4. Documents the provider or member's record with accurate information obtained on the call.
5. Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate.
6. Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues.
7. May serve as a subject matter expert for the Pharmacy team and mentor new employees to the team as necessary.
8. Participates in and contributes to the overall pharmacy quality improvement initiatives.
9. Collects and maintains eligibility information in an appropriate and confidential manner.
10. Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly.
11. Exhibits excellent phone and communication skills while providing complete and accurate information to members.
12. Requests additional or supplemental information via correspondence in order to complete applications.
13. Adheres to assigned schedule and quality metrics.
14. Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders.
15. Follows all policy and procedures for the Medical Assistance Program
16. Performs all other related duties as assigned.
Minimum Required Education, Experience & Skills
Certified Pharmacy Technician (CPhT)
Minimum of High School Diploma or GED
- Minimum of two years of experience in a pharmacy setting with an additional 1 year of experience in a customer service setting.
- Extensive knowledge of the Medicare Part D, particularly the pharmacy record review, claims, billing and reimbursement rules
- Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
- General writing skills and ability to produce work free from typographical or spelling errors.
- Working knowledge of Microsoft Office, Internet and e-mail
Hours can vary 8-5 or 9-6 dependent on work assignment. Also days are either Tues-Saturday or Mon-Fri. This is also dependent on work assignments.
Will you be interviewing (face to face or phone)- Phone
Allmed Staffing Inc