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Pharmacy Technician

1 month ago

Alpharetta, United States SPCPSoutheast Medical Group Full time
Job DescriptionJob DescriptionDescription:

Pharmacy Technician, serves amongst the Customer Services Center in a call center environment and responds to member and client requests/inquiries regarding prescription drug plan coverage or ordering prescriptions through the mail order pharmacy. Assists pharmacies to properly adjudicate electronic prescription drug claims and resolve adjudication error messages. Serves as a liaison between members, pharmacy, clinical, benefit administrators (i.e. clients, TPA’s, etc.), and various internal functional areas.

Requirements:
  1. Provide prompt, accurate responses to caller’s inquiries regarding prescription drug benefit plan information and plan limits to patients and providers within service level performance metrics established
  2. Assists in answering inbound calls related to placing refill prescription orders and processing questions regarding the mail order pharmacy operation.
  3. Assists patients with enrollment into reduced medication copay plans offered by the pharmaceutical companies.
  4. Accurately enter standard and Clinical Prior Authorizations through the Customer Service inbox as well as from Clinical or Client Services.
  5. Process manual eligibility requests for new enrollments, termination, member status changes and COBRA updates.
  6. Produce and mail membership ID cards within specified time and quality parameters based on the previous days eligibility and ad hoc client requests.
  7. Establish members with the mail order pharmacy including transfer of prescriptions.
  8. Respond to customer email inquiries.
  9. Provide basic troubleshooting and support for members using Serve You’s PBM and mail order applications and automated prescription phone service.
  10. Process form letters to members and providers regarding benefit limitations, denial letters, etc.
  11. Manages all queues and email inboxes to ensure members are responded to in a timely manner.
  12. Timely and accurate updates of associated reports, logs and materials.

Preferred Education/Experience/Credentials/ Licensing/Certification

  • High School diploma or GED.
  • One year of customer service experience in a call center environment.
  • An active and valid Certified Pharmacy Technician license, licensed through the Pharmacy Technician Certification Board (PTCB) that is in good standing with no restrictions.

Competencies

  • Knowledgeable in employee health insurance benefits; experience with pharmacy/prescription drugs.
  • Requires excellent communication skills (written and verbal).
  • Demonstrated ability to work effectively with members, staff, and prescribers or customers.
  • Ability to switch between multiple screens/software programs quickly and efficiently to resolve customer concerns while on the telephone.
  • Basic computer skills and experience with Microsoft Word and Excel.
  • Detail oriented, organized and have a sense of urgency to meet service level performance objectives in a fast paced environment.


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