Pharmacy Care Technician Associate
6 days ago
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. We are seeking a highly skilled Pharmacy Care Technician Associate to join our team.
The Pharmacy Care Technician Associate will play a critical role in improving medication adherence and other pharmacy-related quality metrics. This individual will be responsible for gathering prescription refill orders, providing excellent customer service, and determining the eligibility of members applying for the Medical Assistance Program.
Key Responsibilities:
- Conduct a high volume of outbound calls to members to discuss reasons for non-compliant medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow-up information from providers.
- May answer inbound calls from members and assist them with their inquiries. Routes calls to appropriate departments if necessary.
- Follows system scripting and validates member demographic information.
- Documents the provider or member's record with accurate information obtained on the call.
- Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate.
- Provides support to internal staff, subcontractors, and providers with respect to Medicare drug-related issues.
- Participates in and contributes to the overall pharmacy quality improvement initiatives.
- Collects and maintains eligibility information in an appropriate and confidential manner.
- Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly.
- Exhibits excellent phone and communication skills while providing complete and accurate information to members.
- Requests additional or supplemental information via correspondence in order to complete applications.
- Adheres to assigned schedule and quality metrics.
- Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders.
- Follows all policy and procedures for the Medical Assistance Program.
- Performs all other related duties as assigned.
Requirements:
- High School Diploma/GED (or higher)
- Active and unrestricted Pharmacy Technician license in the state of Texas
- National Pharmacy Technician Certification (Certified Pharmacy Technician CPhT)
- 1+ years of experience in a pharmacy setting
- 1+ years of experience in a customer service setting
- 6+ months of previous call center experience
- Basic level of proficiency with Medicare Part D, particularly the pharmacy record review, claims, billing, and reimbursement rules
- Basic level of proficiency with HIPAA Privacy and Security Rules and CMS security requirements
- Basic level of proficiency with writing skills and ability to produce work free from typographical or spelling errors
- Basic level of proficiency with Microsoft Office, Internet, and e-mail, including the ability to produce work free from typos
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