Pharmacy Care Technician Associate

4 weeks ago

San Antonio, Texas, United States Optum Full time
Pharmacy Care Technician Associate Job Description

About the Role:

The Associate Pharmacy Care Technician will play a vital role in improving health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.

Key Responsibilities:

  • Conduct high-volume outbound calls to members to discuss reasons for non-compliance with 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, routing calls to the appropriate department if necessary.
  • Follow system scripting and validate member demographic information.
  • Document the provider or member's record with accurate information obtained on the call.
  • Perform desk and on-site review of all claims documentation to validate correct billing and ensure payment made to contracted pharmacies is supported and appropriate.
  • Provide support to internal staff, subcontractors, and providers with respect to Medicare drug-related issues.
  • Participate in and contribute to the overall pharmacy quality improvement initiatives.
  • Collect and maintain eligibility information in an appropriate and confidential manner.
  • Enter all assigned applications within a specified time frame to ensure eligibility deadlines are met accordingly.
  • Exhibit excellent phone and communication skills while providing complete and accurate information to members.
  • Request additional or supplemental information via correspondence to complete applications.
  • Adhere to assigned schedule and quality metrics.
  • Use a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders.
  • Follow all policy and procedures for the Medical Assistance Program.
  • Perform 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
  • Ability to sit for extended periods of time

Preferred Qualifications:

  • Bilingual (any language)
  • PBM experience
  • Advanced knowledge of NCPDP and other types of prescription drug claims is required
  • Knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies
  • Previous retail pharmacy experience

Optum is an Equal Employment Opportunity / Affirmative Action employer.

UnitedHealth Group is a drug-free workplace.

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