Certified Pharmacy Technician – Call Center Claims Adjudication
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Job Description
Pharmacy Technician working remotely to ensure patient care through phone interactions and claim adjudication tasks. Responsible for customer service and support in a fast-paced environment.
Responsibilities:
- Providing an exceptional customer service experience each day in a phone-based environment
- Answering a high volume of inbound calls from current patients and serve as an ExactCare expert to resolve their questions
- Placing outbound calls to patients to create, maintain or update their medication profiles
- Effectively assist with patient questions over the phone
- Working through current case queues to problem solve for patient care issues
- Serving as a liaison between the clinical pharmacists and other medical professionals on patients’ behalf
- Perform claim adjudication and auditing duties such as prior authorizations, billing and eligibility checks
- Collect on patient balances when patient has an amount due
- Maintaining patient records with strong attention to detail and confidentiality
- Utilizing sound drug knowledge to effectively receive prescription authorizations, clarifications or transfers
- Accurate retrieval of all prescription information and verifying through doctor calls
- Entering a high volume of data; processing prescription information with speed and accuracy
- Placing welcome calls to newly onboarded patients and establish a trusted point of contact
- Partner with technicians and pharmacists to ensure that new patients are successfully onboarded to ExactCare
- Performing in a high volume, fast paced environment to support ExactCare’s nationwide patient base
- Embodying AnewHealth’s Core Values in all communications and interactions
Requirements:
- High school diploma / GED
- Certified with the Pharmacy Technician Certification Board (PTCB) or the National Health Association (NHA) and maintain a current certificate
- Must maintain a pharmacy technician registration with State Board of Pharmacy
- Must be 18+ years of age
- Prior experience in a pharmacy setting
- Comfortable working in a phone-based environment
- Ability to work independently
- Self-motivated and goal oriented
- Exceptional customer service skills; servicing doctor’s office, pharmacist, and patient needs over the phone
- Thorough drug knowledge
- Pharmacy billing knowledge
- Knowledge of appropriate processes in taking prescriptions, clarifications and transfers including clear written and verbal communication
- Ability to utilize computer equipment, technology and work within multiple software programs to receive medication authorizations, clarifications and/or transfers
- Strong prioritization and organizational skills
- Maintain a high degree of confidentiality
- Passion to help people and enrich their lives
- Ability to overcome objections
- Ability to think critically and document pertinent details in a world class manner that is compliant with state and federal regulations
Benefits:
- Medical, dental and vision coverage effective 1st of the month following date of hire
- Flexible spending
- Company-paid life insurance and short-term disability
- Voluntary benefits
- 401(k)
- Paid Time Off
- Paid holidays
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