Certified Pharmacy Technician – Call Center Claims Adjudication

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

📋 Description

• Delivering outstanding customer service experiences daily in a phone-based setting.

• Handling a significant volume of incoming calls from current patients, acting as an ExactCare expert to address their inquiries.

• Making outbound calls to patients to create, update, or maintain their medication profiles.

• Providing effective assistance with patient inquiries over the phone.

• Navigating current case queues to resolve patient care issues.

• Acting as a liaison between clinical pharmacists and other healthcare professionals on behalf of patients.

• Performing claim adjudication and auditing tasks including prior authorizations, billing, and eligibility checks.

• Collecting on patient balances when payments are due.

• Maintaining patient records with meticulous attention to detail and confidentiality.

• Utilizing comprehensive drug knowledge to efficiently receive prescription authorizations, clarifications, or transfers.

• Accurately retrieving all prescription information and verifying it through calls to doctors.

• Entering a high volume of data, processing prescription information with speed and precision.

• Conducting welcome calls to newly onboarded patients, establishing a trusted point of contact.

• Collaborating with technicians and pharmacists to ensure successful onboarding of new patients to ExactCare.

• Functioning effectively in a high-volume, fast-paced environment to support ExactCare’s nationwide patient base.

• Upholding AnewHealth’s Core Values in all communications and interactions.

⛳️ Requirements

• High school diploma or GED.

• Certification from the Pharmacy Technician Certification Board (PTCB) or the National Health Association (NHA), with a current certificate.

• Must hold a pharmacy technician registration with the State Board of Pharmacy.

• Minimum age of 18 years.

• Previous 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, addressing the needs of doctors’ offices, pharmacists, and patients over the phone.

• Comprehensive drug knowledge.

• Familiarity with pharmacy billing.

• Knowledge of appropriate procedures for taking prescriptions, clarifications, and transfers, ensuring clear written and verbal communication.

• Proficient in using computer equipment, technology, and navigating multiple software programs to process medication authorizations, clarifications, and/or transfers.

• Strong organizational and prioritization skills.

• Ability to maintain a high level of confidentiality.

• Passion for helping people and enhancing their lives.

• Capability to overcome objections.

• Critical thinking skills with the ability to document relevant details in a compliant manner that adheres to state and federal regulations.

🏝️ Benefits

• Medical, dental, and vision coverage effective the 1st of the month following the date of hire.

• Flexible spending options.

• Company-paid life insurance and short-term disability.

• Voluntary benefits available.

• 401(k) plan.

• Paid Time Off.

• Paid holidays.