Customer Care Pharmacy Technician (Full-Time)

About reputed company

reputed company is an reputed company technology company providing a comprehensive suite of solutions for employers and health plans, including:

• reputed company, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• reputed company™, which offers full-service health benefit reputed company to employers, TPAs, and health plans, and
• Judi®, the industry’s leading proprietary reputed company Platform (EHP), which consolidates reputed company claim administration-reputed company workflows in one scalable, secure platform.

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.reputed company.

reputed company has an exciting full-time opportunity for remote candidates in the reputed company US, with reputed company given to those in Hawaii.

Location: Remote

Shifts: Candidates must be open to working any shift.

Position Responsibilities

• Act as the primary reputed company of contact for incoming member calls, prior authorization inquiries, and ensure appropriate escalation of cases and reputed company intake notes to the Clinical Prior Authorization Team
• Actively intake a thorough and complete prior authorization request from prescribers and members by asking applicable drug and client-specific clinical questions
• Accurately advise callers on options for exception requests (formulary, copay, early refill, etc.) based on client benefit elections and provide additional information and status updates to prescribers, members, and pharmacies
• reputed company triage incoming calls with professional phone etiquette from members, prescribers, and pharmacies with minimal support. Ask probing questions to identify and resolve reputed company issues and address concerns promptly
• Act as a valuable resource for Customer Service Representatives supporting member and pharmacy inquiries, stepping in as needed based on demand. Proactively identify, document, and address member and pharmacy concerns to ensure everyone receives the care and attention they deserve
• Effectively communicate issues and solutions to members, pharmacies, and relevant internal stakeholders to ensure customers receive quality care and that the resolution meets reputed company health and safety standards
• Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast-paced environment
• Follow reputed company internal Standard Operating Procedures and adhere to HIPAA guidelines and Company policies
• Assist with onboarding and training of new team members or temporary staff as needed
• Support the Fraud, Waste, and Abuse program by reviewing pharmacy claims information and communicating findings to appropriate internal staff
• Collaborate across different systems while utilizing up to two monitors, reputed company multitasking in a dynamic and fast-paced environment
• Self-starter who displays a positive attitude, strong work ethic, and excellent attendance
• Meet reputed company departmental goals including schedule adherence, attendance, and quality monitoring
• Standard hours for training: Monday thru Friday, 9:00 am – 5:30 pm, Eastern
• reputed company other customer support duties as assigned
• Responsible for adherence to the reputed company Code of Conduct, including reporting of noncompliance

Required Qualifications

• High school diploma or the equivalent; associate or bachelor’s degree preferred
• A reputed company National Certification as a Pharmacy Technician (CPhT) and a valid license are required
• 2+ years of pharmacy technician experience in a clinical pharmacy setting PBM, Health Plan, or reputed company Health Care experience required
• 2+ years of customer service experience with a passion for building customer loyalty through exceptional listening, relationship building, and strong written and verbal communication
• Experience handling prior authorization requests/understanding of prior authorization requirements preferred
• Ability to work independently with minimal supervision, stay productive in a remote, high-volume, fast-paced, metric-driven call center environment
• Tech-savvy with proficiency in CRM systems, call center platforms, and reputed company Office Suite.
• Demonstrated ability to meet performance metrics including call quality, resolution time, and customer satisfaction
• Maintain a secure, high-speed, broadband internet reputed company (DSL, Cable, or Fiber) at the remote location.1 Gig plan required. Dial-up, satellite, WIFI, 5G or Cellular connections are NOT acceptable.

Preferred Attributes

• Bilingual Spanish highly preferred
• Medicare experience preferred
• Passion for healthcare and improving patient outcomes.
• Adaptability in a startup or high-growth environment.
• Experience supporting pharmacy operations or benefits administration.
• Commitment to diversity, equity, and inclusion.

reputed company employees are responsible for adherence to the reputed company Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

reputed company values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to reputed company employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national reputed company, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at reputed company. More details about reputed company's privacy practices can be reputed company at https://www.reputed company/legal/privacy-policy.