This is a fully remote position, open to applicants in United States.

📋 Description

• Assist members, providers, and pharmacies with inquiries related to pharmacy services, benefit questions, prior authorization requests, and claims issues.

• Investigate and address pharmacy claims, eligibility, coverage, and medication-related issues while upholding service level expectations.

• Review, document, and process pharmacy transactions and requests in accordance with client, regulatory, and operational standards.

• Utilize various systems and resources to troubleshoot issues, provide solutions, and ensure comprehensive documentation.

• Collaborate with internal teams, healthcare professionals, and external partners to enhance service quality and member satisfaction.

• Assist with pharmacy operations across a range of programs and clients.

• Engage in training and professional development initiatives.

⛳️ Requirements

• Preferably possess an active Certified Pharmacy Technician (CPhT) certification.

• Must have an active Pharmacy Technician registration with the relevant State Board of Pharmacy, if applicable.

• Background in supporting pharmacy operations, prior authorizations, pharmacy claims, PBM services, managed care programs, specialty pharmacy, or healthcare customer service is preferred.

• Excellent customer service, communication, and problem-solving abilities.

• Capability to thrive in a fast-paced, high-volume setting.

• Proficient in using pharmacy systems, various computer applications, and documentation tools.

• Strong accuracy and attention to detail.

🏝️ Benefits

• Flexible work arrangements.

• Opportunities for learning and career advancement.

• Medical insurance options.

• Dental coverage.

• Vision insurance.

• 401(k) plan with company matching.

• Flexible paid time off.

• Paid holidays.

• Wellness initiatives.

• Additional support resources for employees.

• Opportunities for professional development.

• Educational assistance programs.

• Leadership and technical training academies.

• Generous flexible vacation policy.