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

📋 Description

• Assist members, providers, and pharmacies by addressing inquiries related to pharmacy, benefits, prior authorization requests, and claims-related matters.

• Investigate and resolve issues concerning pharmacy claims, eligibility, coverage, and medication while ensuring service level expectations are met.

• Evaluate, document, and process pharmacy transactions and requests in compliance with client, regulatory, and operational standards.

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

⛳️ Requirements

• Current Certified Pharmacy Technician (CPhT) certification is preferred.

• Previous experience in 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.

• Proficient in using pharmacy systems, various computer applications, and documentation tools while ensuring accuracy and attention to detail.