Pharmacy Care Technician Associate

4 weeks ago

San Antonio, Texas, United States UnitedHealth Group Full time
Pharmacy Care Technician Associate Role

At UnitedHealth Group, we are committed to helping people live healthier lives and making the health system work better for everyone. As a Pharmacy Care Technician Associate, you 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 a high volume of outbound calls to members to discuss reasons for non-compliant medication, 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 that 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.

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 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:

• 1+ years of experience in a pharmacy setting

• 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

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