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Pharmacy Call Center Representative

TotalMed Professional Rancho Cucamonga ,CA
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

 

Pay-$16.41/hr

Hours- M-F 8-5p

Bilingual in Spanish and English is preferred

Active state of California Pharmacy Technician license

Position Summary/Position

Under the general direction of the Medi-Cal Pharmacy Call Center Supervisor, the Medi-Cal Pharmacy Call Center Representative is responsible for responding to Provider and/or Member calls in a friendly, professional manner. The Medi-Cal Pharmacy Call Center Representative must be able to utilize all policies and resources to answer questions and direct Providers/Members appropriately in order to resolve their concerns. The Medi-Cal Pharmacy Call Center Representative will need to demonstrate the ability to listen to Provider/Member concerns and questions and be able to accurately communicate health plan processes in a clear and knowledgeable manner

Major Functions

· Communicate with Providers and Member (in English and Spanish) providing information and assistance as appropriate

· Assist Providers with interpreting eligibility and benefit information

· Responsible for handling Argus claims status inquiries, researching and facilitating resolution of payment issues; provider education on formulary concerns and reimbursement issues

Provide assistance with Prior Authorization processing and online claim adjudication with the pharmacy provider

· Provide assistance to members in regards to the Prior Authorization process or the status of their Prior Authorization request

TotalMed Professional

Address

Rancho Cucamonga, CA
USA

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