Pharmacy Help Desk Call Center Representative
Pharmpix Guaynabo, PR
- Posted: over a month ago
This is your chance to unleash your full potential!
PharmPix, is currently seeking for qualified Pharmacy Help Desk Call Center Representative candidate to join our team. We are looking for successful people like you. Join the fastest growing Pharmacy Benefit Management (PBM) company in its category and take your professional career to the next level. PharmPix has become a leading provider of pharmacy benefit solutions and services in the continental United States and the territories.
Our work philosophy is based on commitment, dedication and loyalty. We take care of our employees, just as we ensure the welfare of our clients and partners. If you are creative, service oriented, resourceful and visionary, we would like to hear from you.
The Pharmacy Help Desk Call Center Representative reports to the Pharmacy Help Desk Call Center Supervisor and is responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.
- Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with PharmPix Pharmacy Help Desk Call Center performance metrics.
- Answer incoming providers and beneficiaries calls following Call Center scripts, in a timely matter and in accordance with PharmPix call center performance metrics.
- Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.
- Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.
- Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.
- Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.
- Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment.
- Evaluate on an individual basis to determine if the patient meets the criteria for a coverage determination for alerts such as DURs (Drug Utilization Reviews), HMO (Health Maintenance Organization) among other rejections evaluations required by business.
- Identify system issues and route to the corresponding internal department.
- Perform Special projects and/or other duties assigned by the Operations Manager and or Pharmacy Help Desk Call Center Supervisor.
Essential Roles and Responsibilities
- Pharmacy Technician, Technical or Associate Degree
- Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), or prospect.
- One (1) or two (2) years of customer service or call center experience and healthcare environment, preferred.
- Fully bilingual Spanish and English.
- Proficiency in the use of Microsoft Tools: Excel, Word, Outlook, Office 365, Power Point and industry related software programs.
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