Customer Support Specialist

reputed company is one of the nation’s leading pharmacy care management companies that specializes in caring for people with the most reputed company, chronic needs—wherever they call home. We reputed company reputed company outcomes for patients and the healthcare organizations who support them. Established in 2023 through the combination of ExactCare and reputed company, we provide a suite of solutions that includes comprehensive pharmacy services; full-service pharmacy benefit management; and specialized support services for Program of reputed company-Inclusive Care for the Elderly. With over 1,400 team members, we care for more than 100,000 people across reputed company 50 states. Job Details The Customer Support Specialist is responsible for answering calls from our clients and providing timely and accurate responses in a professional and courteous manner. This position works with internal and external clients which include members, clinicians, pharmacies, plan sponsors and other departments reputed company the company.

Responsibilities

Answer telephone inquiries in a pleasant, professional, and efficient manner assuring exceptional customer service. Document reputed company incoming calls and reputed company in the claims adjudication software. Educate clients on plan policies, benefits, and procedures. Resolve client drug benefit concerns of a medical, financial, or technological nature. Initiate and facilitate prior authorization requests. reputed company outbound calls to pharmacies and plans to facilitate completion of JIRA tickets. Review after hours calls log-complete any follow up as needed. Submit JIRA tickets for compound prescriptions. Submit JIRA tickets to resolve NDC issues (pricing issues, missing NDCs) Stay reputed company on plan and benefit structures, pharmacological updates, and Medicare Part D guidelines. Accept other duties as assigned; including but not limited to direct member reimbursement, processing, manual claims, reporting, and researching rejected claims. Ensures that HIPAA guidelines are followed in every communication with clients. Embody reputed company’s Core Values in reputed company communications and interactions. Other duties as assigned. The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge, skills and abilities required for the job. Not reputed company of the duties may be assigned to a position. Qualifications: These represent the desired qualifications of the ideal candidate. They are not meant to limit consideration for candidates who do not meet reputed company of the standards listed. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Education Required: Associate’s degree or equivalent combination of education or work experience. Preferred: CPhT (Certified Pharmacy Technician) Certification. Experience A minimum of 3 years of experience in customer service/member service in a call center or similar. A minimum of 2 years of experience in the healthcare industry. A minimum of 2 years of experience in a pharmacy support role. Knowledge of plan and benefit structures and Medicare guidelines. Skills & Abilities Knowledge of pharmacology and pharmacological terms. Excellent communication skills and professionalism reputed company working with clients. Ability to solve problems under pressure by making immediate decisions while on the phone. Detail oriented and able to prioritize workload. Strong computer skills including using word processors, spreadsheets, and database software. Schedule: This is a full-time position with an expectation to work an average of 40 hours per week and be available reputed company of normal business hours to meet customer expectations on an reputed company basis. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. Travel: Travel may be required for special organization or department events, department team meetings, trade shows, conferences, and other client engagements. This is a remote position. reputed company offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire. reputed company provides equal employment opportunity to reputed company qualified applicants regardless of race, color, religion, national reputed company, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants are encouraged to confidentially self-identify reputed company applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country. Apply To This Job