Customer Care Pharmacy Support Specialist

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

📋 Description

• Deliver expert assistance for intricate inquiries related to patients, pharmacies, providers, and clients across the designated business lines.

• Verify claim details, eligibility, benefit prerequisites, and other relevant information prior to the authorized reprocessing of claims.

• Reprocess pharmacy claims for authorized partner clients in accordance with client specifications, approved protocols, system permissions, and regulatory guidelines.

• Act as a subject matter expert and escalation contact for Customer Care Advocates concerning pharmacy benefits, claims, systems, and client-specific procedures.

• Follow up with patients to confirm that medication orders are successfully processed.

• Assist patients, providers, and members with the coordination of pharmacy mail order services.

• Manage sensitive and escalated customer interactions that necessitate advanced research, judgment, and problem-solving capabilities.

• Execute authorized pharmacy technician duties in compliance with applicable laws, regulations, organizational procedures, and defined scopes of practice.

• Undertake additional responsibilities as assigned.

• Report directly to the Manager or Supervisor of Customer Care.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• Active registration, license, or certification as a Pharmacy Technician is required.

• Certified Pharmacy Technician (CPhT) credential is preferred.

• 1–2 years of experience in pharmacy or customer service is preferred.

• Experience in processing or reprocessing pharmacy benefit claims is strongly preferred.

• Capability to accurately reprocess pharmacy claims within assigned system permissions and established protocols.

• Strong analytical, troubleshooting, critical-thinking, and problem-solving skills are essential.

• Ability to identify issues that require pharmacist, clinical, configuration, compliance, or leadership input.

• Proficient in working both independently and collaboratively in a fast-paced Customer Care setting.

• Ability to maintain confidentiality and manage sensitive information with integrity.

• Adherence to HIPAA, relevant pharmacy regulations, client requirements, and organizational policies is required.

🏝️ Benefits

• Commitment to equal opportunity employment and non-discrimination.

• Options for Monday-to-Friday shifts.

• Remote work availability as stated in the position location.