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Data Entry Professional
2 months ago
We are seeking a highly skilled Pharmacy Technician Specialist to join our team at Optum. As a key member of our pharmacy operations team, you will play a critical 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.
- 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.
- May serve as a subject matter expert for the Pharmacy team and mentor new employees to the team as necessary.
- 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 in order 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 in order to complete applications.
- Adhere to assigned schedule and quality metrics.
- Follow all policy and procedures for the Medical Assistance Program.
- Active and unrestricted Pharmacy Technician license in the state of Texas.
- National Pharmacy Technician Certification (Certified Pharmacy Technician CPhT).
- 2+ years of experience in a pharmacy setting.
- 1+ years of experience with Medicare Part D, particularly the pharmacy record review, claims, billing, and reimbursement rules.
- 1+ years of experience with HIPAA Privacy and Security Rules and CMS security requirements.
- 1+ years of experience with Microsoft Office, internet, and e-mail.
- Intermediate level of writing skills and ability to produce work free from typographical or spelling errors.
- Advanced knowledge of NCPDP and other types of prescription drug claims.
- Retail pharmacy experience.
- Bilingual (English/Spanish).
At Optum, we are committed to creating a healthier atmosphere by fostering a diverse and inclusive workplace. We offer a comprehensive benefits package, career development opportunities, and a collaborative work environment. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.
