We are seeking a motivated and upbeat healthcare professional to join our growing enterprise Fortune 500 team in the pharmacy department. You will be the primary liaison between the customer and all other departments, assisting them in ordering their prescriptions. We are looking for someone with a background in healthcare, call center experience, and the ability to provide exceptional customer service. Bilingual Spanish candidates preferred but not required.
- Verifies insurance coverage by phone, online or through E1 (electronic system) transactions for all new patients and/or changes in coverage.
- Contacts all new patients (via telephone) to verify the amount(s) that will be paid out-of-pocket/co-pays.
- Maintains confidentiality of information at all times.
- Assists patients with understanding their pharmacy benefits and available resources.
- Educates patients regarding availability of alternative insurance options, such as providing Medicare part D assistance and education.
- Assists when insurance coverage changes between companies or to Medicare, and/or refers patients to a social worker.
- Answers patients’ questions regarding insurance coverage.
- Refers escalated questions/situations to supervisor or appropriate department (such as Billing to address a Billing error), or if a patient wants to opt out of the program.
- Enters patient insurance information under the patient’s account in the pharmacy data system.
- Reviews all enrollment forms. Ensures insurance information and appropriate referrals have been completely and accurately obtained. May be required to follow up with social worker, insurance company, and/or patient to complete the application and verify insurance.
- Demonstrates knowledge and understanding of insurance billing requirements.
- Monitors all patients’ insurance information to ensure that it is updated and accurate. Addresses any identified anomalies or discrepancies, researches and answers questions as needed.
- Analyzes patient reports from pharmacy data system as an audit check to ensure the correct insurance information is entered and that other changes are not overlooked. Researches and corrects any discrepancies identified.
- Prepares monthly reports to track work progress.
- Completes work within authorized time to assure compliance with departmental standards.
- Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
- Assist with various projects as assigned by direct supervisor.
- Other duties as assigned.
- Additional responsibilities may include focus on one or more departments or locations.
- Healthcare or pharmacy experience
- Previous call center experience
- Understanding of medical insurances
- Customer service experience
- Proficiency with Microsoft Office Suite
- Type 50+ WPM
- Excellent customer service, communication, organizational and interpersonal skills required.
- Understands the importance of, and demonstrates a customer service philosophy.
- Excellent written and verbal communication skills.
- Excellent organizational and analytical skills.
- Detail oriented with the ability to enter information accurately into a database system.
- Develops a working knowledge of pharmacy dispensing regulations, pharmacy data systems, and pharmacy billing practices and policies.
- Develops a working knowledge of standard medical abbreviations and medical terminology.
- Licensed/Certified Pharmacy Technicians Preferred, but not required
- High School Diploma required
- Prior courses in insurance billing and data processing preferred.
- Pharmacy Technician Certification preferred.
This will be a full time role working Monday through Friday 9:30 AM - 6:00 PM, with shift hours of 8:00 AM to 4:30 PM during the initial training period.
This position will be eligible for weekly pay, medical, dental, and vision benefits.