Client Services Pharmacy Support Analyst

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

📋 Description

• Conduct research and evaluate customer inquiries related to vendor business lines.

• Interpret relevant policies and procedures to determine suitable actions.

• Acquire benefits, enrollment, and claims information utilizing PCs, manuals, online resources, Imaging, and other systems.

• Address both routine and complex inquiries concerning benefits, claims, billing, enrollment, legal requests, Medicare Secondary Payer, COBRA, reinstatements, conversions, refunds, and similar issues.

• Facilitate job-related training sessions as needed.

• Interact with customers through telephone, written correspondence, in-person meetings, fax, Secure IT, email, and personal interviews.

• Track vendor inquiries using system-generated reports to ensure timely and accurate resolution.

• Provide guidance to relevant plan areas for issue resolution.

• Reach out to internal and external parties to gather information and initiate actions.

• Update inquiries in Facets, manage Sales Force cases, and maintain Work Desk records along with progress notes.

• Notify management of trends and processing issues.

• Assist Marketing personnel and brokers by researching and relaying customer information.

• Engage in marketing initiatives such as open enrollment and on-site visits.

• Participate in ongoing training and acquire new skills.

• Identify, document, and report customer service patterns to the supervisor.

• Uphold conduct that aligns with organizational values.

⛳️ Requirements

• Minimum of 3 years of customer service or correspondence experience, or relevant experience/training in a writing-intensive position.

• High School diploma or equivalent is required.

• Experience in customer interaction is preferred.

• Excellent verbal and written communication skills with a professional demeanor.

• Capability to comprehend and interpret detailed policies and procedures.

• Knowledge of HIPAA regulations concerning the protection of Protected Health Information.

• Ability to work independently and adjust to changing tasks and environments.

• Strong analytical, organizational, and problem-solving abilities.

• Proficient in operating PCs and related software and office equipment.

• Competence in Windows, Outlook, Word, Internet Explorer, Excel, PowerPoint, SharePoint, and Sales Force.

• Above-average skills in reading, writing, and arithmetic.

• Familiarity with Medicare Advantage, Medicare Part D, Medicare Supplemental Programs, Dental, Vision, Chiropractic, Prescription Drug, Benefits Management, and Disease Management.

• Understanding of PBM and Facets health plan administration processing systems.

• Knowledge of benefits administration, billing, claims processing, ERISA, Act 68, BCBSA MTM, PPACA, HIPAA, and Account Administration regulations.

• Willingness to work 37.5 hours per week, including flexible hours, nights, and weekends based on business requirements.

🏝️ Benefits

• Medical, Dental & Vision coverage.

• Retirement Plan.

• Paid Time Off.

• Holidays.

• Volunteer time off.

• Incentive Plan.

• Tuition Reimbursement.

• Flexible schedules.

• Training and continuing education.

• Opportunities for professional and personal growth.

• Community volunteering opportunities.